Provider Demographics
NPI:1083184493
Name:BERGER, MIRIAM (RN)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GOLDERS GREEN RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-7551
Mailing Address - Country:US
Mailing Address - Phone:347-661-1416
Mailing Address - Fax:
Practice Address - Street 1:10 GOLDERS GREEN RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-7551
Practice Address - Country:US
Practice Address - Phone:347-661-1416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-28
Last Update Date:2023-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR20106400163W00000X
NJ25ME00084101176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse