Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | OS015305 | PA |
N | 2081S0010X | Sports Medicine | OS015305 | PA |
N | 213ES0000X | Sports Medicine | OS015305 | PA |
N | 208D00000X | General Practice Physician | OS015305 | PA |
NPI | 1427284439 |
---|---|
Provider Name | William Bergin |
First Address | Johnstown, PA 15905-4327 |
Second Address | Johnstown, PA 15905-4327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2009 |
Last Update Date | 03/01/2017 |