Provider Demographics
NPI:1427260397
Name:ERIC BERGER M.D.
Entity type:Organization
Organization Name:ERIC BERGER M.D.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:M
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-206-5191
Mailing Address - Street 1:108 W MAPLE TREE DR
Mailing Address - Street 2:
Mailing Address - City:WESTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-9600
Mailing Address - Country:US
Mailing Address - Phone:732-206-5191
Mailing Address - Fax:
Practice Address - Street 1:108 W MAPLE TREE DR
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-9600
Practice Address - Country:US
Practice Address - Phone:732-206-5191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA049419002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7010702Medicaid
NJE7008Medicare UPIN
NJ538086Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER