Provider Demographics
NPI:1447263330
Name:BERGER, MINDY R (OD)
Entity type:Individual
Prefix:DR
First Name:MINDY
Middle Name:R
Last Name:BERGER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5105 HARMONY CT
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-1468
Mailing Address - Country:US
Mailing Address - Phone:215-801-7389
Mailing Address - Fax:
Practice Address - Street 1:780 NEWTOWN YARDLEY RD STE 315
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4502
Practice Address - Country:US
Practice Address - Phone:215-968-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270A00543300152W00000X
PAOEG004286152W00000X
NJ27OM00069000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ953061PE6Medicare PIN
U66582Medicare UPIN