Provider Demographics
NPI:1699018846
Name:BERGMAN, BETH (DVM)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:
Last Name:BERGMAN
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:EISENBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DVM
Mailing Address - Street 1:20 CABOT RD
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-1004
Mailing Address - Country:US
Mailing Address - Phone:781-932-5802
Mailing Address - Fax:781-932-5837
Practice Address - Street 1:20 CABOT RD
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-1004
Practice Address - Country:US
Practice Address - Phone:781-932-5802
Practice Address - Fax:781-932-5837
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6320174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian