Provider Demographics
NPI:1851188387
Name:BERKVAM, CHRISTOPHER ALLAN
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ALLAN
Last Name:BERKVAM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 LOMBARD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1184
Mailing Address - Country:US
Mailing Address - Phone:650-464-8342
Mailing Address - Fax:
Practice Address - Street 1:2216 LOMBARD ST APT 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1184
Practice Address - Country:US
Practice Address - Phone:650-464-8342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTBD367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered