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Organization
NEW BERLIN FAMILY PRACTICE
Active
Organization
NEW BERLIN FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER J. HALBERT (CEO)
(607) 847-7000
Entity
Organization
Contact information
Practice address
4 TERRACE HTS, NEW BERLIN, NY 13411-9514
(607) 847-6750
Mailing address
PO BOX 250, 4 TERRACE HEIGHTS, NEW BERLIN, NY 13411-0250
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02160938
—
NY
Enumeration date
05/18/2006
Last updated
08/22/2020
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