Doctor Name: | KARL BERGMANN |
NPI Number: | 1033270681 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 024410 |
Business Practice Address: | 310 Taughannock Blvd Ithaca, NY - 148503251 |
Business Phone Number: | 6072523500 |
Business Fax Number: | |
Mailing Address: | 124 Wood Rd, FREEVILLE |
State: | NY |
Postal Code: | 13068 |
Phone Number: | 7572686954 |
Fax Number: | |
NPI Enumeration Date: | 12/13/2006 |
NPI Last Update Date: | 03/08/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | 024410 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |