Provider Demographics
NPI:1215745864
Name:BERGER, SHANIL
Entity type:Individual
Prefix:
First Name:SHANIL
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6507 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-1623
Mailing Address - Country:US
Mailing Address - Phone:202-910-5178
Mailing Address - Fax:
Practice Address - Street 1:4516 NEW HAMPSHIRE AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-4734
Practice Address - Country:US
Practice Address - Phone:202-910-5178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant