Provider Demographics
NPI:1023557394
Name:BERO, LOVERNA ABELLA (PT DPT)
Entity Type:Individual
Prefix:
First Name:LOVERNA
Middle Name:ABELLA
Last Name:BERO
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 23RD ST APT 1
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-9133
Mailing Address - Country:US
Mailing Address - Phone:862-228-4636
Mailing Address - Fax:
Practice Address - Street 1:266 HARRISTOWN RD STE 304
Practice Address - Street 2:
Practice Address - City:GLEN ROCK
Practice Address - State:NJ
Practice Address - Zip Code:07452-3321
Practice Address - Country:US
Practice Address - Phone:862-228-4636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-18
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041228-1225100000X
NJ40QA01739800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist