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Individual

MR. DOUGLAS T BERGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OPTICIAN

Contact information

Practice address
2169 WHITE PLAINS RD, BRONX, NY 10462-1405
(718) 409-2200
Mailing address
160 SHERMAN AVE, TEANECK, NJ 07666-4123
(917) 553-7708

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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