Provider Demographics
NPI:1063039584
Name:BERMAN, TATYANA (PHARMD)
Entity Type:Individual
Prefix:
First Name:TATYANA
Middle Name:
Last Name:BERMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2261 SUNRISE WAY
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1089
Mailing Address - Country:US
Mailing Address - Phone:267-408-4662
Mailing Address - Fax:
Practice Address - Street 1:7 YORK RD
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-4501
Practice Address - Country:US
Practice Address - Phone:215-443-8113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARPI004430183500000X
PARP442905183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist