Provider Demographics
NPI:1669671046
Name:SCHICHO, BERNEDETTE BRANCH (RN, MSN, APN-C)
Entity Type:Individual
Prefix:
First Name:BERNEDETTE
Middle Name:BRANCH
Last Name:SCHICHO
Suffix:
Gender:F
Credentials:RN, MSN, APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 729
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-0729
Mailing Address - Country:US
Mailing Address - Phone:201-714-2536
Mailing Address - Fax:
Practice Address - Street 1:196 JEWETT AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-1804
Practice Address - Country:US
Practice Address - Phone:201-332-3354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR08769200163W00000X
NJ26NJ00129700363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse