Deborah Berger, PTA, CLT – Physical Therapy Assistant

Key facts

NPI: 1619254216
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapy Assistant 225200000X
License: 40QB00282500 (NJ)
Practice address: 240 Wall St
Suite 100
West Long Branch, NJ 07764-1181
Phone: (732) 222-8556
Fax: (732) 222-8663
NPI assigned: Nov 10, 2011
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Wyatt Medical, LLC Rehabilitation Practitioner · Howell, NJ · NPI 1710938444

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
40QB00282500	NJ	MD	Physical Therapy Assistant

Practice roles

Organization	Specialty	Status	New patients
Wyatt Medical, LLC		Past since May 5, 2008	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapy Assistant	225200000X	40QB00282500	NJ	Yes

Addresses

Primary practice location

240 Wall St
Suite 100
West Long Branch, NJ 07764-1181

Mailing address

123 C St
Brick, NJ 08723-7252
Phone (732) 255-0049

Other providers in West Long Branch, NJ

Victoria Battiato, LAC
Michelle Bayha, LSW
Bazley Physical Therapy Associates
Lisa Connelly Bazley, PT
Robert D Bazley, PT
Gladys Bernabe Crasta, LCSW/MSW
Saul Betesh, MD
Biofeedback and Stress Relief Services LLC
Camille Bivas
Morgan Blanchfield, PA-C

All providers in West Long Branch, NJ · Physical Therapy Assistant in New Jersey

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.