Provider Demographics
NPI:1679598932
Name:BERK, NORLAND FRANKSON (MD)
Entity type:Individual
Prefix:DR
First Name:NORLAND
Middle Name:FRANKSON
Last Name:BERK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1025 NORTHERN BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1506
Mailing Address - Country:US
Mailing Address - Phone:516-627-7607
Mailing Address - Fax:516-626-2737
Practice Address - Street 1:1025 NORTHERN BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1506
Practice Address - Country:US
Practice Address - Phone:516-627-7607
Practice Address - Fax:516-626-2737
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2008-06-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY000988512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY95255Medicare PIN
C12414Medicare UPIN