Healthcare Provider Details

I. General information

NPI: 1053749812
Provider Name (Legal Business Name): ABLAN HOPE BERKO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABLAN LEA KOCOU

II. Dates (important events)

Enumeration Date: 10/14/2013
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

792 MAIN ST
CLINTON MA
01510-1608
US

IV. Provider business mailing address

792 MAIN ST
CLINTON MA
01510-1608
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 866-389-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number2025074054
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN260908
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: