Provider Demographics
NPI:1245232925
Name:BERGMAN, FRANK (DC, FACO)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:BERGMAN
Suffix:
Gender:M
Credentials:DC, FACO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 CANTERBURY RD
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-2311
Mailing Address - Country:US
Mailing Address - Phone:215-945-5879
Mailing Address - Fax:
Practice Address - Street 1:387 STONYBROOK DR
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19055-2021
Practice Address - Country:US
Practice Address - Phone:215-547-0508
Practice Address - Fax:215-547-2430
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC1612111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABE68189Medicare ID - Type Unspecified