Individual
MRS. BERKLEY NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
19 BRADHURST AVE, SUITE 1400, HAWTHORNE, NY 10532-2140
(914) 493-7997
(914) 594-4022
Mailing address
19 BRADHURST AVE, SUITE 1400, HAWTHORNE, NY 10532-2140
(914) 493-7997
(914) 594-4022
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
18437
CA
363LF0000X
Family Nurse Practitioner
Primary
F339223
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04059656
—
NY
05
—
NP18437
—
CA
Enumeration date
12/09/2010
Last updated
04/24/2015
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