Provider Demographics
NPI:1386717635
Name:BERRY, ROBERT H JR (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:BERRY
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 W. MAIN ST.
Mailing Address - Street 2:PO BOX 447
Mailing Address - City:MONTOUR FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14865-0447
Mailing Address - Country:US
Mailing Address - Phone:607-535-7080
Mailing Address - Fax:607-535-7007
Practice Address - Street 1:226 W. MAIN ST.
Practice Address - Street 2:
Practice Address - City:MONTOUR FALLS
Practice Address - State:NY
Practice Address - Zip Code:14865-0447
Practice Address - Country:US
Practice Address - Phone:607-535-7080
Practice Address - Fax:607-535-7007
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008606-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB6446Medicare ID - Type Unspecified