Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 145164 | NY |
NPI | 1043328446 |
---|---|
Provider Name | Stefan Berger |
First Address | Boynton Beach, FL 33473-4970 |
Second Address | Boynton Beach, FL 33473-4970 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2006 |
Last Update Date | 24/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
53A741 | (02) |