Provider Demographics
NPI:1225035645
Name:BERGSON, FRANK N (R,PH)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:N
Last Name:BERGSON
Suffix:
Gender:M
Credentials:R,PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 VIOLET CT
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-2007
Mailing Address - Country:US
Mailing Address - Phone:908-534-6428
Mailing Address - Fax:908-534-6429
Practice Address - Street 1:71 VIOLET CT
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE STATION
Practice Address - State:NJ
Practice Address - Zip Code:08889-2007
Practice Address - Country:US
Practice Address - Phone:908-534-6428
Practice Address - Fax:908-534-6429
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2009-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02178600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist