Provider Demographics
NPI:1437220050
Name:BERGER HENRY ENT SPECIALTY GROUP
Entity type:Organization
Organization Name:BERGER HENRY ENT SPECIALTY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:C
Authorized Official - Last Name:MOREHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-279-1414
Mailing Address - Street 1:60 W GERMANTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401
Mailing Address - Country:US
Mailing Address - Phone:610-279-1414
Mailing Address - Fax:610-279-4725
Practice Address - Street 1:60 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401
Practice Address - Country:US
Practice Address - Phone:610-279-1414
Practice Address - Fax:610-279-4725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011906700001Medicaid
562774OtherAETNA
PA189782OtherBLUE SHIELD OF PA
PA189782Medicare ID - Type Unspecified