Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DI 19824 | NJ |
NPI | 1154476570 |
---|---|
Provider Name | Dr. Elaina Berd-Vergier |
First Address | Englewood, NJ 07631-4152 |
Second Address | Englewood, NJ 07631-4152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 08/07/2007 |