Provider Demographics
NPI:1154088136
Name:DANIELLE BERGER PLLC
Entity Type:Organization
Organization Name:DANIELLE BERGER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGER BERKSETH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:218-349-2293
Mailing Address - Street 1:919 W CENTRAL ENTRANCE
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-5469
Mailing Address - Country:US
Mailing Address - Phone:877-442-4476
Mailing Address - Fax:
Practice Address - Street 1:919 W CENTRAL ENTRANCE
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-5469
Practice Address - Country:US
Practice Address - Phone:877-442-4476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center