Individual
MRS. MARY KATHERINE BERENGUER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
AUDIOLOGIST
Contact information
Practice address
825 FAIRFAX AVE, NORFOLK, VA 23507-1914
(757) 446-7483
(757) 624-2272
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-0374
(757) 624-2272
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2201001127
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-004
CIGNA
VA
01
—
289301
UNITED HEALTHCARE/MAMSI
VA
01
—
PAR
MIDATLANTIC/VICARE
VA
Enumeration date
01/31/2006
Last updated
07/09/2007
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