Provider Demographics
NPI:1962474312
Name:BERMAN, EUGENE MARTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:MARTIN
Last Name:BERMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 35TH AVE
Mailing Address - Street 2:SIDE DOOR 88 ST
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-5701
Mailing Address - Country:US
Mailing Address - Phone:718-458-2292
Mailing Address - Fax:
Practice Address - Street 1:8801 35TH AVE
Practice Address - Street 2:SIDE DOOR 88 ST
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-5701
Practice Address - Country:US
Practice Address - Phone:718-458-2292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0268271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice