ERIC BERGMAN MPAS08-AMC NPI 1891917381

NPI Information

NPI: 1891917381
Provider Name: ERIC BERGMAN, MPAS08-AMC
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: NORTHEAST MEDICAL GROUP INC

PECOS Registration: Yes

Address:
20 YORK ST, CB-2041
NEW HAVEN, CT
ZIP 06510
Phone: (203) 688-4748
Get Directions

Eric Bergman, MPAS08-AMC is a medical physician assistant in New Haven, CT with 16 years of experience. Eric Bergman, MPAS08-AMC NPI is 1891917381. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

20 YORK ST, CB-2041
NEW HAVEN, CT
ZIP 06510-220
Phone: (203) 688-4748
Fax: (203) 688-4741

The NPI 1891917381 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/3/2007 and was last updated on 4/3/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208M00000X	Hospitalist		002113	CONNECTICUT	No
2	363A00000X	Physician Assistant		002113	CONNECTICUT	No
3	363AM0700X	Physician Assistant	Medical	002113	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	002113	OTHER	CONNECTICUT	LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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