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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174554703 | NPPES |
| New York | Other | BD5450 | ATLANTIS |
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