Provider Demographics
NPI:1699745182
Name:BERMAN, LEWIS (MD)
Entity type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:
Last Name:BERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3852
Mailing Address - Country:US
Mailing Address - Phone:203-852-2254
Mailing Address - Fax:203-852-2738
Practice Address - Street 1:24 STEVENS ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3852
Practice Address - Country:US
Practice Address - Phone:203-852-2254
Practice Address - Fax:203-852-2738
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT030673207RP1001X, 207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010030673CT03OtherANTHEM B/C
CT306730OtherCONNECTICARE
CTOV5526OtherHEALTHNET
CT1254943OtherUNITED HEALTHCARE
CT566097OtherAETNA PROVIDER NUMBER
CT7183763-002OtherCIGNA
CTZS433OtherOXFORD HEALTHCARE
CT001306738Medicaid
E71289Medicare UPIN
110007738Medicare ID - Type UnspecifiedMEDICARE NUMBER