Provider Demographics
NPI:1457579252
Name:BERRY, DEANENE V (AUD)
Entity Type:Individual
Prefix:DR
First Name:DEANENE
Middle Name:V
Last Name:BERRY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:DEANENE
Other - Middle Name:V
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:2 UNIVERSITY PLZ STE 226
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-6210
Mailing Address - Country:US
Mailing Address - Phone:201-645-5440
Mailing Address - Fax:201-645-5443
Practice Address - Street 1:2 UNIVERSITY PLZ STE 630
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-6210
Practice Address - Country:US
Practice Address - Phone:201-645-5440
Practice Address - Fax:201-645-5443
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006035231H00000X
CT000631231H00000X
CT00631237600000X
NJ25MG00109400237600000X
NJ41YA00072700231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter