Individual
MRS. CINDY LEE BERGENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
77 CHICAGO AVE, STATEN ISLAND, NY 10305-3757
(718) 442-7828
Mailing address
77 CHICAGO AVE, STATEN ISLAND, NY 10305-3757
(718) 442-7828
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
319054
NY
Other
Enumeration date
10/14/2011
Last updated
12/24/2012
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