Provider Demographics
NPI:1710604509
Name:BERGER, ANDREW DEAN (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DEAN
Last Name:BERGER
Suffix:
Gender:M
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 STENTON AVE APT 14K
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-3251
Mailing Address - Country:US
Mailing Address - Phone:215-595-3662
Mailing Address - Fax:
Practice Address - Street 1:9896 BUSTLETON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-5202
Practice Address - Country:US
Practice Address - Phone:215-934-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC018765225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist