Provider Demographics
NPI:1922187830
Name:BERGER, ALAN W (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:W
Last Name:BERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E 32ND ST
Mailing Address - Street 2:SUITE #102
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6058
Mailing Address - Country:US
Mailing Address - Phone:212-689-6252
Mailing Address - Fax:212-213-8305
Practice Address - Street 1:150 E 32ND ST
Practice Address - Street 2:SUITE #102
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6058
Practice Address - Country:US
Practice Address - Phone:212-689-6252
Practice Address - Fax:212-213-8305
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY194269207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01562165Medicaid
NY01562165Medicaid
26M872Medicare ID - Type Unspecified
26M871Medicare ID - Type Unspecified