Basic Information
Provider Information
NPI: 1073689436
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BERMAN
FirstName: SHARON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2 MERIDIAN BLVD
Address2: SECOND FLOOR
City: WYOMISSING
State: PA
PostalCode: 196103202
CountryCode: US
TelephoneNumber: 6103724957
FaxNumber:  
Practice Location
Address1: 6 HEARTHSTONE CT
Address2: SUITE 200
City: READING
State: PA
PostalCode: 196063065
CountryCode: US
TelephoneNumber: 6107799550
FaxNumber: 6107796433
Other Information
ProviderEnumerationDate: 11/28/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XRN255975LPAY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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