Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 305521 | NY |
Y | 207P00000X | Emergency Physician | MD467598 | PA |
N | 207P00000X | Emergency Physician | MT211617 | PA |
N | 207PE0004X | Emergency Medical Services | MD467598 | PA |
NPI | 1134574122 |
---|---|
Provider Name | Christopher Leonard Berry |
First Address | Sayre, PA 18840-1625 |
Second Address | Sayre, PA 18840-1625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2016 |
Last Update Date | 05/03/2021 |