Provider Demographics
NPI:1861433922
Name:BERMAN, JEFFREY M (M/D/)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:BERMAN
Suffix:
Gender:M
Credentials:M/D/
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 RYDAL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RYDAL
Mailing Address - State:PA
Mailing Address - Zip Code:19046-1711
Mailing Address - Country:US
Mailing Address - Phone:267-620-1100
Mailing Address - Fax:215-572-1279
Practice Address - Street 1:1095 RYDAL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RYDAL
Practice Address - State:PA
Practice Address - Zip Code:19046-1711
Practice Address - Country:US
Practice Address - Phone:267-620-1100
Practice Address - Fax:215-572-1279
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD062570L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000451204OtherAMERIHEALTH
PA1143253OtherKEYSTONE MERCY
PA231937219OtherTRICARE
PW000451204OtherHIGHMARK BLUE SHIELD
PA0140618000OtherKEYSTONE EAST
PA14617OtherHEALTH PARTNERS
PA100012734OtherPALMETTO GBA
PA017720580003Medicaid
PA231937219OtherMULTIPLAN
PA1167811002OtherCIGNA
PA231937219OtherDEVON
PA5234726OtherAETNA
PAP2784785OtherOXFORD
PA000451204OtherPERSONAL CHOICE
PA231937219OtherFIRST HEALTH
PW000451204OtherHIGHMARK BLUE SHIELD