Provider Demographics
NPI:1053110593
Name:BERGER, JOSHUA D (PMHNP)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:D
Last Name:BERGER
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 ROBIN DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3069
Mailing Address - Country:US
Mailing Address - Phone:718-360-6373
Mailing Address - Fax:
Practice Address - Street 1:635 DUQUESNE BLVD STE 3
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-5073
Practice Address - Country:US
Practice Address - Phone:646-907-9480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15281900364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty