Individual
DARA BERGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
11241 QUEENS BLVD, SUITE 100, FOREST HILLS, NY 11375-5564
(718) 544-0770
(718) 261-5522
Mailing address
11241 QUEENS BLVD, SUITE 100, FOREST HILLS, NY 11375-5564
(718) 544-0770
(718) 261-2262
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
005450
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BD5450
ATLANTIS
NY
Enumeration date
07/05/2006
Last updated
02/02/2009
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