Provider Demographics
NPI:1588612378
Name:BERGER, RICHARD S (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:BERGER
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 1:2210 CONRAD WAY
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-6099
Mailing Address - Country:US
Mailing Address - Phone:732-356-8581
Mailing Address - Fax:
Practice Address - Street 1:1543 STATE HIGHWAY 27
Practice Address - Street 2:SUITE 31
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3904
Practice Address - Country:US
Practice Address - Phone:732-297-8866
Practice Address - Fax:732-821-0626
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA27997207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
223777917OtherCOMMERCIAL INSURANCES
NJC60211Medicare UPIN
NJ199731BDKMedicare PIN
NJ420215P0HMedicare ID - Type Unspecified