Individual
CAROL VERONICA BERGERON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6207
(631) 548-6223
Mailing address
66 OLEETA RD, MOUNT SINAI, NY 11766-2507
(631) 331-2129
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F 301900-1
NY
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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