MEDICARE: RUSSELL SCOTT BERMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086X0206X	Surgical Oncology Physician	186818	NY

General Provider Information

NPI Number	:	1710988506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUSSELL SCOTT BERMAN M.D.

Provider Business Mailing Address
First Line	:	160 E 34TH ST
Second Line	:	9TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10016-4750
Country	:	US
Telephone Number	:	212-731-5365
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 E 34TH ST
Second Line	:	9TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10016-4750
Country	:	US
Telephone Number	:	212-731-5365
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	01/24/2025

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