Provider Demographics
NPI:1447854302
Name:BERMAN, ELIZABETH (INDEPENDENT PROVIDER)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BERMAN
Suffix:
Gender:F
Credentials:INDEPENDENT PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6278 LAKEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-2117
Mailing Address - Country:US
Mailing Address - Phone:440-463-6897
Mailing Address - Fax:
Practice Address - Street 1:6278 LAKEWOOD CT
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-2117
Practice Address - Country:US
Practice Address - Phone:440-463-6897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-22
Last Update Date:2020-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker