Individual
BRUCE LEE BERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1050 CLOVE RD, STATEN ISLAND, NY 10301-3627
(718) 816-6440
(718) 816-3749
Mailing address
2791 RICHMOND AVE, SUITE 201, STATEN ISLAND, NY 10314-5859
(718) 816-6440
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
185296-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01504489
—
NY
Enumeration date
08/19/2006
Last updated
11/12/2012
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