Berg, Debra Ellen

Berg, Debra Ellen is an individual health care provider with primary practice located at 900 Intervale Ave Archcare Senior Life, Bronx NY 10459-4240. She recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as her primary health care specialty. Berg, Debra Ellen can be contacted via phone (718) 732-7165.

Contact Information

Primary practice address
900 Intervale Ave Archcare Senior Life Bronx NY 10459-4240
Phone: (718) 732-7165
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 208450 New York

Profile Details

NPI number 1700821832
LBN Legal business name Berg, Debra Ellen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2006
Last updated Dec 14th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700821832 NPPES
New York MEDICAID 03067907
New York Other 208450

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