Provider Demographics
NPI:1902876055
Name:BERGER, SONDRA K (DPM)
Entity Type:Individual
Prefix:
First Name:SONDRA
Middle Name:K
Last Name:BERGER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:SONDRA
Other - Middle Name:BERGER
Other - Last Name:DARVIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3 PINE WEST PLZ STE 306
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-5522
Mailing Address - Country:US
Mailing Address - Phone:518-456-3668
Mailing Address - Fax:
Practice Address - Street 1:3 PINE WEST PLZ STE 306
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5522
Practice Address - Country:US
Practice Address - Phone:518-456-3668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005963213ES0131X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
000407063001OtherBS OF NE NY
6202441OtherGHI CBPPPO
PJ048OtherEMPIRE BCBS
245003OtherWELLCARE
9313757OtherPHCS PPO
NY02A79165Medicaid
79594OtherGHI HMO
P3297178OtherOXFORD
10075790OtherCDPHP
364739OtherMVP
5162828000OtherMAGNACARE
364739OtherMVP
5162828000OtherMAGNACARE
U97206Medicare UPIN