Search › Rhode Island › 171100000X

Jason Bergman, DAC

NPI 1427215631 · on the registry since 2008 · sole proprietor

Practice

Address
172 Broadway
Providence, RI 02903
Phone
(401) 523-3253
Clinicians at this address
2

Registry record

Primary taxonomy
171100000X
171100000X
Licence states on file
RI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2008-05-16

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Rhode Island