Provider Demographics
NPI:1538146352
Name:BERMAN, ALAN N (DPM)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:N
Last Name:BERMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 STONELEIGH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-3940
Mailing Address - Country:US
Mailing Address - Phone:845-278-8400
Mailing Address - Fax:845-278-4326
Practice Address - Street 1:664 STONELEIGH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-3940
Practice Address - Country:US
Practice Address - Phone:845-278-8400
Practice Address - Fax:845-278-4326
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTP00365213E00000X
NYN736991213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0886020001OtherMEDICARE
T51200Medicare UPIN
NYP39302Medicare PIN