Provider Demographics
NPI:1609959121
Name:BERAN, NANCY R (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:R
Last Name:BERAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:190 GOLDENS BRIDGE RD
Mailing Address - Street 2:WESTCHESTER HEALTH ASSOCIATES
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-2810
Mailing Address - Country:US
Mailing Address - Phone:914-401-8020
Mailing Address - Fax:914-232-3366
Practice Address - Street 1:645 MARBLE AVE
Practice Address - Street 2:
Practice Address - City:THORNWOOD
Practice Address - State:NY
Practice Address - Zip Code:10594
Practice Address - Country:US
Practice Address - Phone:914-769-1600
Practice Address - Fax:914-769-1610
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2011-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2157192207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02281074Medicaid
NY849271Medicare PIN
NY02281074Medicaid