Provider Demographics
NPI:1497723688
Name:BERARDI, JOSEPH RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:RICHARD
Last Name:BERARDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3580 SHERIDAN DRIVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4123
Mailing Address - Country:US
Mailing Address - Phone:716-839-4949
Mailing Address - Fax:
Practice Address - Street 1:3580 SHERIDAN DRIVE
Practice Address - Street 2:SUITE 150
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-4123
Practice Address - Country:US
Practice Address - Phone:716-839-4949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112531207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA0579Medicare UPIN