Individual
DR. MICHAEL JAMES BERARDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3671 OLD YORKTOWN RD, SHRUB OAK, NY 10588-1503
(914) 962-1234
(914) 962-1312
Mailing address
3671 OLD YORKTOWN RD, SHRUB OAK, NY 10588-1503
(914) 962-1234
(914) 962-1312
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X-005871-1
NY
111NS0005X
Sports Physician Chiropractor
X005871-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015178
GHI ID
NY
05
—
3I025202853
—
NY
01
—
C05871-1
WORK COMP
NY
01
—
P439476
OXFORD ID
NY
Enumeration date
06/22/2005
Last updated
09/23/2020
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