Recaredo T Berbano PC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

MD418104 Issued in PA

Legal business name

RECAREDO T BERBANO PC

Practice address

445 Wyoming Avenue
Kingston, PA 18704

Phone

(570) 718-0520

Fax

(570) 718-0522

NPI assigned

May 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Recaredo Trinidad Berbano Jr., MD

Title

Medical Doctor Owner

Phone

(570) 718-0520

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jill Crompton Sandutch, CRNP-C

  • Family Nurse Practitioner
  • Wilkes Barre, PA
  • NPI 1598996829
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1649491911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 WYOMING AVENUE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "18704",
            "telephone_number": "570-718-0520",
            "fax_number": "570-718-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 WYOMING AVENUE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "18704",
            "telephone_number": "570-718-0520",
            "fax_number": "570-718-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECAREDO T BERBANO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "BERBANO",
        "authorized_official_first_name": "RECAREDO",
        "authorized_official_middle_name": "TRINIDAD",
        "authorized_official_title_or_position": "MEDICAL DOCTOR OWNER",
        "authorized_official_telephone_number": "570-718-0520",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "MD418104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001887950",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zahra Rajaeian, CRNP
• Michael C Raklewicz, MD
• Melissa Ramage
• Reaching Beyond Limits
• Reaching Beyond Limits Behavioral Health, LLC
• Recaredo T. Berbano, M.D.,P.C.
• Deanna Redman, BS
• Regenerative Physical Medicine LLC
• Kayla Reilly, M.S BCBA/LBS
• Harvey James Reiser, MD

• Endocrinology, Diabetes & Metabolism Physician in Kingston, PA
• Providers in Kingston, PA by specialty
• Endocrinology, Diabetes & Metabolism Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.