Provider Demographics
NPI:1417051459
Name:BERGER, WILLIAM S (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:BERGER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:743 DELSEA DR N
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-1435
Mailing Address - Country:US
Mailing Address - Phone:856-582-0098
Mailing Address - Fax:856-582-2331
Practice Address - Street 1:743 DELSEA DR N
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-1435
Practice Address - Country:US
Practice Address - Phone:856-582-0098
Practice Address - Fax:856-582-2331
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ3805152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist