Provider Demographics
NPI:1538497037
Name:BERGIN, DANA ANN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:ANN
Last Name:BERGIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:ANN
Other - Last Name:CAUDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PROGRESSIVE PHYSICAL THERAPY, PC
Mailing Address - Street 2:700 BROADWAY
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-6621
Mailing Address - Country:US
Mailing Address - Phone:516-797-7003
Mailing Address - Fax:516-797-7336
Practice Address - Street 1:PROGRESSIVE PHYSICAL THERAPY, PC
Practice Address - Street 2:700 BROADWAY
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-6621
Practice Address - Country:US
Practice Address - Phone:516-797-7003
Practice Address - Fax:516-797-7336
Is Sole Proprietor?:No
Enumeration Date:2009-11-23
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01337600225100000X
NY034390225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist