Provider Demographics
NPI:1851324263
Name:DR. ANDREW M. BERMAN, OPTOMETRIST P.A.
Entity Type:Organization
Organization Name:DR. ANDREW M. BERMAN, OPTOMETRIST P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:M
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:302-678-1000
Mailing Address - Street 1:PO BOX 537
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19903-0537
Mailing Address - Country:US
Mailing Address - Phone:302-678-1000
Mailing Address - Fax:302-678-2374
Practice Address - Street 1:446 S NEW ST
Practice Address - Street 2:NEW VISION CARE CENTER
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-6725
Practice Address - Country:US
Practice Address - Phone:302-678-1000
Practice Address - Fax:302-678-2374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEI3-0001136152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000025322Medicaid
DET26892Medicare UPIN
DE0000025322Medicaid