Individual provider Active NPI

Bonnie H. Berman

  • Specialist
  • Commack, NY
National Provider Identifier
1861832271
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1748177 Issued in NY
Practice address
4 Golden Ridge CT
Commack, NY 11725-2020
Phone
(631) 664-3347
NPI assigned
Jun 28, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1748177 NY Primary

Addresses

Primary practice location

4 Golden Ridge CT
Commack, NY 11725-2020

Mailing address

4 Golden Ridge CT
Commack, NY 11725-2020
Phone (631) 664-3347

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1748177NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1861832271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GOLDEN RIDGE CT",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252020",
            "telephone_number": "631-664-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GOLDEN RIDGE CT",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252020",
            "telephone_number": "631-664-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "BONNIE",
        "middle_name": "H.",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1748177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; 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.