Provider Demographics
NPI:1760520266
Name:BERGER, JOSHUA SOLOMON (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:SOLOMON
Last Name:BERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2700 WESTCHESTER AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-2547
Mailing Address - Country:US
Mailing Address - Phone:914-681-3146
Mailing Address - Fax:914-457-1198
Practice Address - Street 1:3333 HENRY HUDSON PKWY
Practice Address - Street 2:SUITE 1B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463
Practice Address - Country:US
Practice Address - Phone:718-543-0900
Practice Address - Fax:718-601-0387
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1162541207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00215238Medicaid
325301Medicare ID - Type Unspecified
C08500Medicare UPIN