Provider Demographics
NPI:1912206491
Name:MARC BERSON AND MONICA MARTOCCI LLP
Entity Type:Organization
Organization Name:MARC BERSON AND MONICA MARTOCCI LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:BERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-439-3937
Mailing Address - Street 1:2804 WALBERT AVE
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2400
Mailing Address - Country:US
Mailing Address - Phone:610-439-1917
Mailing Address - Fax:
Practice Address - Street 1:2804 WALBERT AVE
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2400
Practice Address - Country:US
Practice Address - Phone:610-439-1917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-23
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty