Provider Demographics
NPI:1255637666
Name:BERK, ELI ZACHARY (DC)
Entity type:Individual
Prefix:DR
First Name:ELI ZACHARY
Middle Name:
Last Name:BERK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 RUSSELL ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-3534
Mailing Address - Country:US
Mailing Address - Phone:413-584-9888
Mailing Address - Fax:413-584-3095
Practice Address - Street 1:234 RUSSELL ST STE 201
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-3534
Practice Address - Country:US
Practice Address - Phone:413-584-9888
Practice Address - Fax:413-584-3095
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-02
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012124-1111NR0400X
MA3478111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS300199096OtherMEDICARE ID