Basic Information
| Provider Information | |||||||||
| NPI: | 1053361303 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERGER | ||||||||
| FirstName: | HARRY | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1605 N CEDAR CREST BLVD | ||||||||
| Address2: | SUITE 110B | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181042351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109731410 | ||||||||
| FaxNumber: | 6109731449 | ||||||||
| Practice Location | |||||||||
| Address1: | 281 N 12TH ST | ||||||||
| Address2: | SUITE B | ||||||||
| City: | LEHIGHTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 182351101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103777793 | ||||||||
| FaxNumber: | 6103779241 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2006 | ||||||||
| LastUpdateDate: | 01/06/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD021112E | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 086604 | 01 | PA | HIGHMARK PA BLUE SHIELD | OTHER | 01056102 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 00079839000003 | 05 | PA | MEDICAID | 110190143 | 01 | PA | PALMETTO GBA MEDICARE | OTHER |