Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | 25MA09439600 | NJ |
Y | 2086S0120X | Pediatric Surgery | C10010496 | DE |
NPI | 1144495003 |
---|---|
Provider Name | Loren Berman |
First Address | Rockland, DE 19732-0191 |
Second Address | Newtown Square, PA 19073 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2008 |
Last Update Date | 18/07/2018 |