Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 20913 | CO |
NPI | 1063027225 |
---|---|
Provider Name | Barry Berlin |
First Address | Denver, CO 80202-2277 |
Second Address | Denver, CO 80202-2277 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2020 |
Last Update Date | 14/09/2020 |