Provider Demographics
NPI:1770199697
Name:BERTA, ANDREW BRETT (DPT)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:BRETT
Last Name:BERTA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 AULT CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1707
Mailing Address - Country:US
Mailing Address - Phone:302-753-9002
Mailing Address - Fax:
Practice Address - Street 1:2060 LIMESTONE RD STE 201
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5500
Practice Address - Country:US
Practice Address - Phone:302-999-9202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist