Individual
JEFFREY BERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5625 MYRTLE AVE, RIDGEWOOD, NY 11385-4740
(718) 497-5470
(718) 386-0532
Mailing address
5625 MYRTLE AVE, RIDGEWOOD, NY 11385-4740
(718) 497-5470
(718) 386-0532
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV004883
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023183381
STORE NPI
—
Enumeration date
06/10/2009
Last updated
06/10/2009
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