Provider Demographics
NPI:1164629846
Name:BERMAN, DORIE E (PT)
Entity Type:Individual
Prefix:MS
First Name:DORIE
Middle Name:E
Last Name:BERMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:PINE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07058-9621
Mailing Address - Country:US
Mailing Address - Phone:973-715-4401
Mailing Address - Fax:973-808-7159
Practice Address - Street 1:27 WINDSOR DR
Practice Address - Street 2:
Practice Address - City:PINE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07058-9621
Practice Address - Country:US
Practice Address - Phone:973-715-4401
Practice Address - Fax:973-808-7159
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00164900171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor