Individual provider · Type 1 NPI

Shannon Emily Berg I

Specialist · Port Jefferson Station, NY

NPI number 1659237048 Active

Practice location

299 Hallock Ave
Port Jefferson Station, NY 11776-1217

Call (631) 473-4284 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X1969516251 (NY)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1659237048

Shannon Emily Berg I's National Provider Identifier is 1659237048, issued on Dec 29, 2025. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Port Jefferson Station, NY. The record was last updated on Dec 29, 2025.