Provider Demographics
NPI:1508892282
Name:BERGER, ERIC (MD)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:BERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 NAUTILUS DR
Mailing Address - Street 2:STE 2
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2490
Mailing Address - Country:US
Mailing Address - Phone:609-978-3170
Mailing Address - Fax:609-978-4321
Practice Address - Street 1:108 W MAPLE TREE DR
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-9600
Practice Address - Country:US
Practice Address - Phone:732-281-3590
Practice Address - Fax:732-281-0054
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA0494919002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE70008Medicare UPIN
NJ538086CKVMedicare PIN
NJ538086Medicare PIN