Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 275206 | NY |
NPI | 1013283514 |
---|---|
Provider Name | Ms. Dana Rachel Berg |
First Address | Valhalla, NY 10595-1530 |
Second Address | Valhalla, NY 10595-1530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2012 |
Last Update Date | 30/07/2020 |