Individual
MRS. JANE ELIZABETH BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
3975 CONSHOHOCKEN AVE, PHILADELPHIA, PA 19131-5426
(215) 879-1000
(215) 879-3912
Mailing address
1407 LUTHER ST, BETHLEHEM, PA 18018-4814
(610) 694-9303
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL006199L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019271510003
—
PA
Enumeration date
04/16/2007
Last updated
04/17/2013
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