Provider Demographics
NPI:1477352821
Name:BERGH, CAROLINE (PT)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:BERGH
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 PARK DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-2823
Mailing Address - Country:US
Mailing Address - Phone:267-664-0667
Mailing Address - Fax:
Practice Address - Street 1:2600 PHILMONT AVE STE 111
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-5307
Practice Address - Country:US
Practice Address - Phone:215-647-2112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025036225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist