Provider Demographics
NPI:1831359330
Name:BERGER, EMILY M (MD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:BERGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 POLIFLY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1758
Mailing Address - Country:US
Mailing Address - Phone:551-996-8697
Mailing Address - Fax:
Practice Address - Street 1:3550 MARKET ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3329
Practice Address - Country:US
Practice Address - Phone:914-441-0582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4456680207NP0225X
NJ25MA09367700207NP0225X
NY257580207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology