Healthcare Provider Details

I. General information

NPI: 1205998622
Provider Name (Legal Business Name): ANDREA BEREZ MS RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 05/11/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 CAMBRIDGE DR
WARREN NJ
07059-6940
US

IV. Provider business mailing address

17 CAMBRIDGE DR
WARREN NJ
07059-6940
US

V. Phone/Fax

Practice location:
  • Phone: 973-420-9789
  • Fax:
Mailing address:
  • Phone: 973-420-9789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: