Provider Demographics
NPI:1780725424
Name:BERMAN, DAWN (APN)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:BERMAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:LOVELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:1355 CAMPUS PKWY
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-6833
Mailing Address - Country:US
Mailing Address - Phone:732-202-8071
Mailing Address - Fax:
Practice Address - Street 1:1355 CAMPUS PKWY
Practice Address - Street 2:
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07753-6833
Practice Address - Country:US
Practice Address - Phone:732-202-8071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN11005500363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP24385Medicare UPIN
NJ045223Medicare ID - Type Unspecified