Bergen, Dara

Bergen, Dara is an sole proprietor health care provider with primary practice located at 11241 Queens Blvd Suite 100, Forest Hills NY 11375-5564. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Bergen, Dara can be contacted via phone (718) 544-0770.

Contact Information

Primary practice address
11241 Queens Blvd Suite 100 Forest Hills NY 11375-5564
Phone: (718) 544-0770
Fax: (718) 261-5522
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 005450 New York

Profile Details

NPI number 1174554703
LBN Legal business name Bergen, Dara
Credentials Registered Dietitian (RD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 5th, 2006
Last updated Feb 2nd, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174554703 NPPES
New York Other BD5450 ATLANTIS

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