Individual
ERIC BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPAS08-AMC
Contact information
Practice address
20 YORK ST, CB-2041, NEW HAVEN, CT 06510-3220
(203) 688-4748
(203) 688-4741
Mailing address
20 YORK STREET CB-2041, NEW HAVEN, CT 06510
(203) 688-4748
(203) 688-4740
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
002113
CT
363A00000X
Physician Assistant
002113
CT
363AM0700X
Medical Physician Assistant
Primary
002113
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002113
LICENSE
CT
Enumeration date
05/03/2007
Last updated
04/03/2015
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