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NPI Code Detail

MEDICARE: DR. ANTHONY BERSON M.D.

MEDICARE: DR. ANTHONY BERSON 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
1174400000XSpecialist1836091NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881691301
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTHONY BERSON M.D.
Provider Business Mailing Address
First Line : 325 W 15TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10011-5903
Country : US
Telephone Number : 212-604-6081
Fax Number : 212-367-1742
Provider Business Practice Location Address
First Line : 325 W 15TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10011-5903
Country : US
Telephone Number : 212-604-6081
Fax Number : 212-367-1742
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 07/08/2007

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