Provider Demographics
NPI:1841203551
Name:BERGER, NANCY CAROL (DC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:CAROL
Last Name:BERGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1727
Mailing Address - Street 2:22 CENTER ST.
Mailing Address - City:VINEYARD HAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02568-0910
Mailing Address - Country:US
Mailing Address - Phone:508-693-4668
Mailing Address - Fax:508-696-6349
Practice Address - Street 1:22 CENTER ST.
Practice Address - Street 2:
Practice Address - City:VINEYARD HAVEN
Practice Address - State:MA
Practice Address - Zip Code:02568
Practice Address - Country:US
Practice Address - Phone:508-693-4668
Practice Address - Fax:508-696-6349
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACH484111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY35312OtherBLUE CROSS/BLUE SHIELD