Provider Demographics
NPI:1992825459
Name:BERGER, JEFFREY SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:BERGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:525 W CHESTER PIKE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-4500
Mailing Address - Country:US
Mailing Address - Phone:610-789-7767
Mailing Address - Fax:610-789-7768
Practice Address - Street 1:1204 BALTIMORE PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-7373
Practice Address - Country:US
Practice Address - Phone:610-789-7767
Practice Address - Fax:610-789-7768
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS014096208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA158810Medicare PIN