Healthcare Provider Details

I. General information

NPI: 1982719050
Provider Name (Legal Business Name): ANN CLARKE BERKERY PHD, APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 SHERMAN AVE
BERKELEY HEIGHTS NJ
07922-1171
US

IV. Provider business mailing address

7 SILVER LAKE DR
SUMMIT NJ
07901-3233
US

V. Phone/Fax

Practice location:
  • Phone: 908-464-5711
  • Fax: 908-598-0413
Mailing address:
  • Phone: 908-598-1289
  • Fax: 908-598-0413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: