Provider Demographics
NPI:1629243779
Name:MAKAR, BERNADETTE MARIE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:BERNADETTE
Middle Name:MARIE
Last Name:MAKAR
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:BERNADETTE
Other - Middle Name:MARIE
Other - Last Name:CAPUTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:254 EASTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901
Mailing Address - Country:US
Mailing Address - Phone:908-239-5711
Mailing Address - Fax:
Practice Address - Street 1:254 EASTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901
Practice Address - Country:US
Practice Address - Phone:908-239-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN11513800363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health