Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 164214 | NY |
N | 207VG0400X | Gynecologist | 164214 | NY |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 164214 | NY |
N | 207VX0000X | Obstetrician | 164214 | NY |
NPI | 1427070655 |
---|---|
Provider Name | Dr. David Bergman |
First Address | Mineola, NY 11501-4198 |
Second Address | Mineola, NY 11501-4198 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 13/03/2017 |