Provider Demographics
NPI:1033705843
Name:BERMAN, RICHARD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:BERMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 BLAIR MILL RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1751
Mailing Address - Country:US
Mailing Address - Phone:215-830-9760
Mailing Address - Fax:215-830-9802
Practice Address - Street 1:2101 BLAIR MILL RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1751
Practice Address - Country:US
Practice Address - Phone:215-830-9760
Practice Address - Fax:215-830-9802
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP043661L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist