Individual
PROF. GERARD THOMAS BERRY SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON CHILDREN'S HOSPITAL, BOSTON, MA 02115-5724
(617) 857-4636
(617) 730-4874
Mailing address
3 BLACKFAN CIR, SUITE 14070, BOSTON, MA 02115-5713
(617) 355-4316
(617) 730-4874
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
MD018408E
PA
207SG0202X
Clinical Biochemical Genetics Physician
Primary
230307
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008577400005
—
PA
01
—
3786201
USHC
—
01
—
BE117913
BLUE SHIELD
—
Enumeration date
01/20/2006
Last updated
01/11/2013
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