Provider Demographics
NPI:1396153920
Name:DONALD A. BERGMAN MD PC
Entity type:Organization
Organization Name:DONALD A. BERGMAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-876-7333
Mailing Address - Street 1:1199 PARK AVE
Mailing Address - Street 2:SUITE 1F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1713
Mailing Address - Country:US
Mailing Address - Phone:212-876-7333
Mailing Address - Fax:212-876-5351
Practice Address - Street 1:1199 PARK AVE
Practice Address - Street 2:SUITE 1F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1713
Practice Address - Country:US
Practice Address - Phone:212-876-7333
Practice Address - Fax:212-876-5351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty