Richard Berg, DO

Individual provider Active NPI Family Medicine Physician · Hancock, NY

NPI 1770526840 · NPPES record last updated Apr 27, 2021

Key facts

NPI
1770526840
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
238543 (NY)
Practice address
116 E Front St
Hancock, NY 13783-1242
Phone
(607) 637-5700
Fax
(607) 637-5703
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 238543 NY Yes

Addresses

Primary practice location

116 E Front St
Hancock, NY 13783-1242

Mailing address

116 E Front St
Hancock, NY 13783-1242
Phone (607) 637-5700

Other identifiers

IdentifierTypeStateIssuer
02731639MedicaidNY

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address richard.berg@direct.lourdes.com Direct

Other providers in Hancock, NY

All providers in Hancock, NY · Family Medicine Physician in New York

Sources for this page

Verify at the official NPI Registry.