Provider Demographics
NPI:1154857928
Name:BERGENFIELD, HANNAH CECILIA (RN)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:CECILIA
Last Name:BERGENFIELD
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 1:110 LIVINGSTON ST
Mailing Address - Street 2:APT 7F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5011
Mailing Address - Country:US
Mailing Address - Phone:609-977-2282
Mailing Address - Fax:
Practice Address - Street 1:110 LIVINGSTON ST
Practice Address - Street 2:APT 7F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5011
Practice Address - Country:US
Practice Address - Phone:609-977-2282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY725120163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse