Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 301667 | NY |
N | 204F00000X | Transplant Surgeon | 48466 | KY |
N | 208200000X | Surgeon | 4301102547 | MI |
N | 208600000X | Surgeon | 4301102547 | MI |
N | 208200000X | Surgeon | NA | MD |
N | 208600000X | Surgeon | NA | MD |
NPI | 1265579932 |
---|---|
Provider Name | Dr. Jonathan Carlin Berger |
First Address | Lexington, KY 40536-0284 |
Second Address | New York, NY 10016-4907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 20/10/2020 |