Basic Information
| Provider Information | |||||||||
| NPI: | 1144495003 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERMAN | ||||||||
| FirstName: | LOREN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 191 | ||||||||
| Address2: | |||||||||
| City: | ROCKLAND | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197320191 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026516212 | ||||||||
| FaxNumber: | 3026514945 | ||||||||
| Practice Location | |||||||||
| Address1: | 3855 W CHESTER PIKE | ||||||||
| Address2: | SUITE 280 | ||||||||
| City: | NEWTOWN SQUARE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105574800 | ||||||||
| FaxNumber: | 6105574816 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2008 | ||||||||
| LastUpdateDate: | 07/18/2018 | ||||||||
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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 | 2086S0120X | 25MA09439600 | NJ | N | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery | 2086S0120X | C10010496 | DE | Y | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery |
No ID Information.