Provider Demographics
NPI:1417905803
Name:BERKS NEUROSURGERY ASSOC LTD
Entity Type:Organization
Organization Name:BERKS NEUROSURGERY ASSOC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:K
Authorized Official - Last Name:HOLM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-373-4007
Mailing Address - Street 1:606 MUSEUM RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1427
Mailing Address - Country:US
Mailing Address - Phone:610-373-4007
Mailing Address - Fax:610-374-1412
Practice Address - Street 1:606 MUSEUM RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:PA
Practice Address - Zip Code:19611-1427
Practice Address - Country:US
Practice Address - Phone:610-373-4007
Practice Address - Fax:610-374-1412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD011904E207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA474463OtherHIGHMARK
PA03019700OtherCAP B CROSS
PA474463Medicare PIN
E55510Medicare UPIN