Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 46TR00428700 | NJ |
NPI | 1811162191 |
---|---|
Provider Name | Melissa Hernando Berardino |
First Address | Holmdel, NJ 07733-1035 |
Second Address | Oceanport, NJ 07757-1162 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2008 |
Last Update Date | 02/08/2011 |