Provider Demographics
NPI:1770982415
Name:BERR, ADAM D (ATP)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:D
Last Name:BERR
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 KINGS HWY E
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-1206
Mailing Address - Country:US
Mailing Address - Phone:856-524-7349
Mailing Address - Fax:856-524-7349
Practice Address - Street 1:425 KINGS HWY E
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-1206
Practice Address - Country:US
Practice Address - Phone:856-524-7349
Practice Address - Fax:856-216-8266
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJATP614174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist