Individual
DR. DEBRA ELLEN BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
900 INTERVALE AVE, ARCHCARE SENIOR LIFE, BRONX, NY 10459-4240
(718) 732-7165
Mailing address
900 INTERVALE AVE, ARCHCARE SENIOR LIFE, BRONX, NY 10459-4240
(718) 732-7165
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
208450
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03067907
—
NY
01
—
208450
NY STATE LIC NUMBER
NY
Enumeration date
06/20/2006
Last updated
12/14/2015
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