Individual
BRANDY BERGERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29 BEATTIE AVE, LOCKPORT, NY 14094-5002
(716) 807-1917
Mailing address
29 BEATTIE AVE, LOCKPORT, NY 14094-5002
(716) 807-1917
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
277127
NY
Other
Enumeration date
11/20/2008
Last updated
11/20/2008
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