Provider Demographics
NPI:1740630664
Name:BERGER, GEORGIA (DPT)
Entity type:Individual
Prefix:
First Name:GEORGIA
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:GEORGIA
Other - Middle Name:
Other - Last Name:SPANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:8015 FRANKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19136-2736
Mailing Address - Country:US
Mailing Address - Phone:215-338-8900
Mailing Address - Fax:215-338-8923
Practice Address - Street 1:8015 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-2736
Practice Address - Country:US
Practice Address - Phone:215-338-8900
Practice Address - Fax:215-338-8923
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025340225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist