Provider Demographics
NPI:1821062118
Name:BERGMAN, CYNTHIA A (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:BERGMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 RINGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-2714
Mailing Address - Country:US
Mailing Address - Phone:215-346-2213
Mailing Address - Fax:215-657-5905
Practice Address - Street 1:721 DRESHER RD STE 2400
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2218
Practice Address - Country:US
Practice Address - Phone:215-346-2213
Practice Address - Fax:215-657-5905
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PWMD059002174400000X
PAMD059002L207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG26567Medicare UPIN
PA867006Medicare ID - Type Unspecified