Provider Demographics
NPI:1093369969
Name:BERGADO, ZEFANNE P (OD)
Entity Type:Individual
Prefix:DR
First Name:ZEFANNE
Middle Name:P
Last Name:BERGADO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 CHRISTIANA RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-3040
Mailing Address - Country:US
Mailing Address - Phone:302-322-4444
Mailing Address - Fax:
Practice Address - Street 1:169 CHRISTIANA RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-3040
Practice Address - Country:US
Practice Address - Phone:302-322-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEI4-0000102152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist