Individual
GARY ROBERT BERK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 MAIN ST, HERMON, NY 13652-3100
(315) 347-2191
(315) 347-4493
Mailing address
105 MAIN ST, HERMON, NY 13652-3100
(315) 347-2191
(315) 347-4493
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1671441
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00986576
—
NY
Enumeration date
09/05/2006
Last updated
07/16/2024
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