Provider Demographics
NPI:1851502991
Name:BERMAN, NADJA (PT)
Entity Type:Individual
Prefix:MRS
First Name:NADJA
Middle Name:
Last Name:BERMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8238 E 33RD ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-1406
Mailing Address - Country:US
Mailing Address - Phone:512-619-0929
Mailing Address - Fax:
Practice Address - Street 1:6400 S LEWIS AVE
Practice Address - Street 2:STE 1500
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1088
Practice Address - Country:US
Practice Address - Phone:800-728-1115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3970225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist