Provider Demographics
NPI:1235468711
Name:ROBERT F BERKE-SCHLESSEL,
Entity Type:Organization
Organization Name:ROBERT F BERKE-SCHLESSEL,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BERKE
Authorized Official - Last Name:SCHLESSEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-624-0006
Mailing Address - Street 1:2 CHURCH ST S
Mailing Address - Street 2:SUITE 504
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1717
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 CHURCH ST S
Practice Address - Street 2:SUITE 504
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1717
Practice Address - Country:US
Practice Address - Phone:203-624-0006
Practice Address - Fax:203-562-4694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty