Provider Demographics
NPI:1013601889
Name:BERARD-CELY, GUERDINE
Entity Type:Individual
Prefix:
First Name:GUERDINE
Middle Name:
Last Name:BERARD-CELY
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 1:60 CLIFF ST # 1
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-1841
Mailing Address - Country:US
Mailing Address - Phone:857-237-4833
Mailing Address - Fax:
Practice Address - Street 1:60 CLIFF ST # 1
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-1841
Practice Address - Country:US
Practice Address - Phone:857-237-4833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN91539164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse