Individual
DR. JACK JICCHAK BERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3030 WESTCHESTER AVE, PURCHASE, NY 10577-2574
(914) 682-6511
(914) 607-6280
Mailing address
3030 WESTCHESTER AVE, PURCHASE, NY 10577-2574
(914) 682-6511
(914) 607-6280
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
038356
CT
207RR0500X
Rheumatology Physician
Primary
132057
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000045882
GHI HMO
NY
01
—
0051090
GHI PPO
NY
05
—
00597755
—
NY
01
—
0D1950/3C1296
HEALTH NET
NY
01
—
132057
CONNECTICARE
NY
01
—
132057-1W
WORKERS COMPENSATION
NY
01
—
133884168
BEECH STREET
NE
01
—
133884168
EMPIRE STATE PLAN (NYS)
NY
01
—
1721079-005
CIGNA
NY
01
—
2178760
AETNA HMO
NE
01
—
4540891
AETNA NON HMO
NE
01
—
461517
UNITED HEALTH CARE
NY
01
—
517105
PHCS
NY
01
—
51A531
BLUE CROSS PPO
NY
01
—
WP461
OXFORD
NY
Enumeration date
12/13/2005
Last updated
01/21/2016
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