Provider Demographics
NPI:1841537248
Name:BERKMAN, MARJORIE (PTA)
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:
Last Name:BERKMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 WINSLOW AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2501
Mailing Address - Country:US
Mailing Address - Phone:617-628-6263
Mailing Address - Fax:
Practice Address - Street 1:72 WINSLOW AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2501
Practice Address - Country:US
Practice Address - Phone:617-628-6263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant