Dr. Michele Shoshana Bergen
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
49 Lake Ave
Greenwich
, Connecticut 06830-4501
Dr. Michele Shoshana Bergen
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
49 Lake Ave
Greenwich
, Connecticut 06830-4501
(203) 661-0155
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Michele Shoshana Bergen
- 49 Lake Ave
- Greenwich, CT
- Zip : 06830-4501
- Fax : (203) 661-0155
- Phone : (203) 661-4231
Second Address
- Dr. Michele Shoshana Bergen
- 49 Lake Ave
- Greenwich, CT
- Zip : 06830-4501
- Fax : (203) 661-0155
- Phone : (203) 661-4231
Reviews
FAQs
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Is Dr. Michele Shoshana Bergen a sole practitioner?
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Does Dr. Michele Shoshana Bergen have any license restrictions?
Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 009275 | CT |
| N | 1223S0112X | Oral and Maxillofacial Surgeon | 050181 | NY |
| N | 204E00000X | Oral & Maxillofacial Surgeon | 042206 | CT |
| N | 204E00000X | Oral & Maxillofacial Surgeon | 231685 | NY |
National Provider Identifier
| NPI | 1215929286 |
|---|---|
| Provider Name | Dr. Michele Shoshana Bergen |
| First Address | Greenwich, CT 06830-4501 |
| Second Address | Greenwich, CT 06830-4501 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/08/2005 |
| Last Update Date | 08/08/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 001422063 | (05) | CT |
| I23887 | (02) | CT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.