Provider Demographics
NPI:1619948346
Name:BERENGUER, MARY KATHERINE (AUDIOLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:KATHERINE
Last Name:BERENGUER
Suffix:
Gender:F
Credentials:AUDIOLOGIST
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:KATHERINE
Other - Last Name:HOKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUDIOLOGIST
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-0374
Mailing Address - Fax:757-624-2272
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-7483
Practice Address - Fax:757-624-2272
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001127231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA-004OtherCIGNA
VA289301OtherUNITED HEALTHCARE/MAMSI
VAPAROtherMIDATLANTIC/VICARE