DR. LARA VON BERG (NPI# 1558623330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558623330 |
| Entity Type | Individual |
| Full Name | DR. LARA VON BERG |
| Credential | M.D., M.P.H. |
| Practice Address |
11 Overlook Rd Ste 100 Summit NJ 07901-3580 |
| Mailing Address |
Po Box 416457 Boston MA 02241-6457 |
| Practice Telephone | 9082731493 |
| Mailing Telephone | 8443621735 |
| Mailing Fax Number | 9732907495 |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2019-02-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 25MA09617100 | NJ | Allopathic & Osteopathic Physicians |
| Street Address |
11 OVERLOOK RD STE 100 |
| City | SUMMIT |
| State | NJ |
| Zip Code | 07901-3580 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790242212 | Elizabeth Russo Putnam | Occupational Therapist | 88 Mountain Ave, Summit, NJ 07901 | 2019-02-21 |
| 1821536152 | Nyree Tchalikian | Social Worker | 467 Springfield Avenue, Suites 201-202, Summit, NJ 07901 | 2017-02-07 |
| 1891149050 | Trucare Homehealth Services, Inc | Health Maintenance Organization | 86 Summit Ave Suite Ll200, Summit, NJ 07901 | 2016-04-14 |
| 1043672975 | Brendan P. Mccollum, Md LLC | Clinic/Center | 33 Overlook Rd., Suite 210, Summit, NJ 07901 | 2016-03-21 |
| 1972917086 | Family and Sports Medicine Institute of New Jersey LLC | Physical Medicine & Rehabilitation | 33 Upper Overlook Rd, Suite 305, Summit, NJ 07901 | 2014-06-17 |
| 1639589666 | Adonis Cheng | Physician Assistant | Overlook Medical Center, 99 Beauvoir Avenue, Summit, NJ 07901 | 2014-04-29 |
| 1932542693 | Brian Patrick Thornton Jr. | Counselor | 33 Upper Overlook Road, Suite 210, Summit, NJ 07901 | 2013-04-12 |
| 1285977371 | Rehab Universe, LLC | Clinic/Center | 137 Springfield Ave, 2nd Floor, Summit, NJ 07901 | 2013-03-27 |
| 1568702348 | Summit Board of Education | Local Education Agency (LEA) | 14 Beekman Terrace, Summit, NJ 07901 | 2013-02-15 |
| 1538418082 | Dana N Cohen | Psychologist | 86 Summit Avenue, Summit Psychological Services, Summit, NJ 07901 | 2012-08-30 |
| Find all providers in zip 07901 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295374312 | Adreece Sanders | Family Medicine | 5292 Irene Rd, Summit, MS 39666-5640 | 2020-01-06 |
| 1851683833 | Sarah Marie Murray | Family Medicine | 11 Overlook Rd Ste 140, Summit, NJ 07901-3577 | 2011-05-09 |
| 1194829408 | Jozef J Rzucidlo | Family Medicine | 5838 S Harlem Ave, Summit, IL 60501-1407 | 2006-09-08 |
| 1134236599 | David S. Snow | Family Medicine | 7900 Highway 570, Summit, MS 39666-7563 | 2006-08-23 |
| 1174588834 | Jennifer Gholson | Family Medicine | 804 Robb St, Summit, MS 39666-8291 | 2006-04-18 |
| 1295707156 | Elizabeth Fagan | Family Medicine | 12 Bank St Ste 201, Summit, NJ 07901-3661 | 2006-02-06 |
| 1477085660 | James Kostek | Family Medicine | 99 Beauvoir Ave, Summit, NJ 07901-3533 | 2017-03-28 |
| 1003262783 | Lauren H Im-imamura | Family Medicine | 99 Beauvoir Ave, Summit, NJ 07901-3533 | 2016-05-11 |
| 1336568419 | Christina Nicole Johnson | Family Medicine | 99 Beauvoir Ave, Summit, NJ 07901 | 2014-04-15 |
| 1528313061 | Tatiana Petrikova | Family Medicine | 36500 Aurora Dr, Summit, WI 53066-4899 | 2012-07-20 |
| Find all providers in SUMMIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.