Doctor Name: | EILEEN M BERGE |
NPI Number: | 1235337593 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 212132 |
Business Practice Address: | 95 Sargent Street Belchertown, MA - 010079881 |
Business Phone Number: | 4133235016 |
Business Fax Number: | 4139672524 |
Mailing Address: | 280 Chestnut Street, 2nd Fl SPRINGFIELD |
State: | MA |
Postal Code: | 011991619 |
Phone Number: | 4137945700 |
Fax Number: | |
NPI Enumeration Date: | 07/10/2007 |
NPI Last Update Date: | 09/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 212132 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |