Provider Demographics
NPI:1972597920
Name:BERKS DERMATOLOGY PC
Entity type:Organization
Organization Name:BERKS DERMATOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:AINSWORTH
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:610-927-3880
Mailing Address - Street 1:2208 QUARRY DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WEST LAWN
Mailing Address - State:PA
Mailing Address - Zip Code:19609-1158
Mailing Address - Country:US
Mailing Address - Phone:610-927-3880
Mailing Address - Fax:610-927-0787
Practice Address - Street 1:2208 QUARRY DR
Practice Address - Street 2:SUITE 206
Practice Address - City:WEST LAWN
Practice Address - State:PA
Practice Address - Zip Code:19609-1158
Practice Address - Country:US
Practice Address - Phone:610-927-3880
Practice Address - Fax:610-927-0787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Single Specialty