Healthcare Provider Details

I. General information

NPI: 1831261296
Provider Name (Legal Business Name): ANDREA VICENTE BERNINGER R.N., NPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 03/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15011 HILLSIDE AVE
JAMAICA NY
11432-3319
US

IV. Provider business mailing address

37 CAMDEN PL
NEW HYDE PARK NY
11040-3601
US

V. Phone/Fax

Practice location:
  • Phone: 718-739-5778
  • Fax: 718-523-2728
Mailing address:
  • Phone: 516-739-1830
  • Fax: 718-523-2728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number467187
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF401165-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: