Individual
DR. BERTHA A JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
212 E 106TH ST, NEW YORK, NY 10029-4007
(212) 360-2600
(212) 360-2618
Mailing address
230 E 71ST ST, 3F, NEW YORK, NY 10021-5130
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
199399
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355151
—
NY
Enumeration date
08/26/2005
Last updated
03/22/2012
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