Individual
DR. ELLIS JAY BERZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD056238L
PA
207L00000X
Anesthesiology Physician
Primary
MD056238L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018097570005
—
PA
Enumeration date
02/03/2006
Last updated
01/09/2008
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