Individual
JACINDA BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(917) 279-2513
Mailing address
6596 160TH ST, APT 2E, FRESH MEADOWS, NY 11365-2564
(917) 279-2513
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F306042-1
NY
Other
Enumeration date
02/20/2013
Last updated
02/20/2013
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