Provider Demographics
NPI:1952488868
Name:HERMAN B. BERG M.D., P.C.
Entity Type:Organization
Organization Name:HERMAN B. BERG M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HERMAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-352-6200
Mailing Address - Street 1:5515 LITTLE NECK PKWY
Mailing Address - Street 2:SUITE L10
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-2244
Mailing Address - Country:US
Mailing Address - Phone:718-352-6200
Mailing Address - Fax:718-352-6777
Practice Address - Street 1:5515 LITTLE NECK PKWY
Practice Address - Street 2:SUITE L10
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-2244
Practice Address - Country:US
Practice Address - Phone:718-352-6200
Practice Address - Fax:718-352-6777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty