Provider Demographics
NPI:1275938177
Name:BERNKNOPF, VIOLET
Entity Type:Individual
Prefix:MRS
First Name:VIOLET
Middle Name:
Last Name:BERNKNOPF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HARTFORD DR STE 1
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4945
Mailing Address - Country:US
Mailing Address - Phone:732-212-0150
Mailing Address - Fax:732-784-9170
Practice Address - Street 1:4 HARTFORD DR STE 1
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07701-4945
Practice Address - Country:US
Practice Address - Phone:732-212-0150
Practice Address - Fax:732-784-9170
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00520400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily