Individual
JEFFREY JOSEPH BERAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
15953 N GREENWAY HAYDEN LOOP STE A, SCOTTSDALE, AZ 85260-1765
(480) 767-2769
(480) 361-9734
Mailing address
15953 N GREENWAY HAYDEN LOOP STE A, SCOTTSDALE, AZ 85260-1765
(480) 767-2769
(480) 361-9734
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7398
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669520235
NIP
AZ
01
—
2Z8898
HEALTH NET NUMBER
AZ
01
—
454198977
TAX ID
AZ
01
—
610640800
GROUP OWCP NUMBER
AZ
01
—
AZ0461720
GROUP NUMBER
AZ
Enumeration date
01/08/2007
Last updated
09/12/2019
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