Provider Demographics
NPI:1639256142
Name:BERMAN, STEVEN E (PHD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:E
Last Name:BERMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 ROUTE 70 SUITE 27
Mailing Address - Street 2:SJ MEDICAL CENTER
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034
Mailing Address - Country:US
Mailing Address - Phone:856-795-5502
Mailing Address - Fax:856-751-0777
Practice Address - Street 1:1401 ROUTE 70 E STE 27
Practice Address - Street 2:SJ MEDICAL CENTER
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2207
Practice Address - Country:US
Practice Address - Phone:856-795-5502
Practice Address - Fax:856-751-0777
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YB00000800231H00000X
NJ235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ080293Medicare ID - Type Unspecified
S55585Medicare UPIN