Individual
DR. PATRICK R. BERGEVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
(570) 882-3007
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
(570) 882-3007
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
121069-1
NY
207RH0003X
Hematology & Oncology Physician
Primary
MD043681-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016665380001
—
PA
05
—
00640560
—
NY
Enumeration date
02/07/2006
Last updated
07/08/2007
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