Provider Demographics
NPI:1184614794
Name:BERGSTEIN, KAREN (CNM, WHNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BERGSTEIN
Suffix:
Gender:F
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 FERRIS DR
Mailing Address - Street 2:
Mailing Address - City:GARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10524-3217
Mailing Address - Country:US
Mailing Address - Phone:845-821-0793
Mailing Address - Fax:
Practice Address - Street 1:450 MAMARONECK AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-2400
Practice Address - Country:US
Practice Address - Phone:914-421-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420714-01363LW0102X
NYF000553367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYM7M141OtherEMPIRE BCBS #
NY000000053323OtherGHI HMO #
NY1000016825OtherAFFINITY HEALTH PLAN #
NY167019OtherCONNECTICARE #
NY02098075Medicaid
NY208587OtherWELLCARE #
NY5066679OtherAETNA PPO #
NY0D3127OtherHEALTHNET #
NY2256606OtherAETNA HMO #
NY400222OtherMVP #
NYP2105935OtherOXFORD #
NY1899885OtherGHI PPO #
NYF000553OtherHIP #
NYBK0553OtherATLANTIS HEALTH PLAN #
NYF000553OtherHIP #
NY2256606OtherAETNA HMO #