Individual
MR. DOUGLAS T BERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Taxonomy
Speciality
Code
Description
License number
State
156FC0800X
Contact Lens Technician/Technologist
C005104-1
NY
156FC0801X
Contact Lens Fitter
C005104-1
NY
156FX1800X
Optician
Primary
C005104-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00960458
—
NY
Enumeration date
01/03/2007
Last updated
09/21/2011
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