Provider Demographics
NPI:1811993645
Name:BERMAN, PAUL ROBERT (CRNA)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:ROBERT
Last Name:BERMAN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2413 FAIRWAY TER
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2059
Mailing Address - Country:US
Mailing Address - Phone:215-491-4566
Mailing Address - Fax:
Practice Address - Street 1:2413 FAIRWAY TER
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2059
Practice Address - Country:US
Practice Address - Phone:215-491-4566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN510473L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA054041Medicare ID - Type Unspecified