Individual
BENJAMIN BERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 ROUTE 112 STE B, PORT JEFFERSON STATION, NY 11776-8055
(631) 978-7633
(631) 621-4115
Mailing address
1500 ROUTE 112 STE B, PORT JEFFERSON STATION, NY 11776-8055
(631) 978-7633
(631) 621-4115
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
336636
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2019
Last updated
08/28/2025
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