Provider Demographics
NPI:1740715994
Name:BERGERON, CHERYL (RNFA)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:BERGERON
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:372 JANES CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07863-3505
Mailing Address - Country:US
Mailing Address - Phone:201-513-6606
Mailing Address - Fax:
Practice Address - Street 1:372 JANES CHAPEL RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NJ
Practice Address - Zip Code:07863-3505
Practice Address - Country:US
Practice Address - Phone:201-513-6606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO11804300163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant