Basic Information
| Provider Information | |||||||||
| NPI: | 1215175435 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERLIN | ||||||||
| FirstName: | ANA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 90 BERGEN ST | ||||||||
| Address2: | DOCTOR'S OFFICE CENTER (DOC) SUITE 7100 | ||||||||
| City: | NEWARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 071032425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9739722400 | ||||||||
| FaxNumber: | 9739722988 | ||||||||
| Practice Location | |||||||||
| Address1: | 90 BERGEN ST | ||||||||
| Address2: | DOCTOR'S OFFICE CENTER (DOC) SUITE 7100 | ||||||||
| City: | NEWARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 071032425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9739722400 | ||||||||
| FaxNumber: | 9739722988 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2009 | ||||||||
| LastUpdateDate: | 12/04/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 25MA09523400 | NJ | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.