Berke, Steven L
Berke, Steven L is an sole proprietor health care provider with primary practice located at 130 New London Tpke , Norwich CT 06360-2624. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Pathology, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Berke, Steven L can be contacted via phone (860) 886-0651.Contact Information
Primary practice address
130 New London Tpke
Norwich CT 06360-2624
Phone: (860) 886-0651
Fax: (860) 823-1577
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Pathology | 1223P0106X | 006728 | Connecticut |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 006728 | Connecticut |
Profile Details
| NPI number | 1275527772 |
|---|---|
| LBN Legal business name | Berke, Steven L |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 12th, 2005 |
| Last updated | Sep 30th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275527772 | NPPES |
| Connecticut | Other | 190000670 | MEDICARE |
| Connecticut | Other | 020006728CT01 | MEDICARE |
| Connecticut | Other | 5477144 | MEDICARE |
| Connecticut | MEDICAID | 004083333 | MEDICARE |
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