| Doctor Name: | ELIZABETH C BERRY |
| NPI Number: | 1124433016 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA1461 |
| Business Practice Address: | 27 Portland Rd Buxton, ME - 040936530 |
| Business Phone Number: | 2079296500 |
| Business Fax Number: | |
| Mailing Address: | 73 Emery St, #1 PORTLAND |
| State: | ME |
| Postal Code: | 041023728 |
| Phone Number: | 2183102104 |
| Fax Number: | |
| NPI Enumeration Date: | 06/30/2014 |
| NPI Last Update Date: | 03/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA1461 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |