Provider Demographics
NPI:1184609547
Name:BERGER, SCOTT ANDREW (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:ANDREW
Last Name:BERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:188 RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-2435
Mailing Address - Country:US
Mailing Address - Phone:718-948-0132
Mailing Address - Fax:718-948-0132
Practice Address - Street 1:2619A ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207
Practice Address - Country:US
Practice Address - Phone:718-485-7760
Practice Address - Fax:718-485-7780
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1538272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry