Provider Demographics
NPI:1336128206
Name:BERMAN, DANIEL SOLOMON (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:SOLOMON
Last Name:BERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4 STRALISK CT UNIT 403
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-8922
Mailing Address - Country:US
Mailing Address - Phone:718-633-7828
Mailing Address - Fax:718-577-5916
Practice Address - Street 1:491 STATE ROUTE 208 STE 211
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-1656
Practice Address - Country:US
Practice Address - Phone:718-633-7828
Practice Address - Fax:718-577-5916
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155841207R00000X
FLME156927207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01018097Medicaid
FL115227400Medicaid
FLPQ298OtherMEDICARE