Provider Demographics
NPI:1043205206
Name:BERGER, DAVID L (PT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:L
Last Name:BERGER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 CENTRAL PARK AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1068
Mailing Address - Country:US
Mailing Address - Phone:914-725-0180
Mailing Address - Fax:914-725-0181
Practice Address - Street 1:495 CENTRAL PARK AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1068
Practice Address - Country:US
Practice Address - Phone:914-725-0180
Practice Address - Fax:914-725-0181
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ88201Medicare ID - Type Unspecified