Provider Demographics
NPI:1396943742
Name:BERKEY, KENT E (MD)
Entity type:Individual
Prefix:
First Name:KENT
Middle Name:E
Last Name:BERKEY
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 1:3245 BEECHWOOD BLVD APT B23
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-3130
Mailing Address - Country:US
Mailing Address - Phone:412-521-2231
Mailing Address - Fax:724-229-6199
Practice Address - Street 1:1025 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-2119
Practice Address - Country:US
Practice Address - Phone:724-229-6195
Practice Address - Fax:724-229-6199
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042802L2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1435835Medicaid
PA1435835Medicaid
PAF49607Medicare UPIN