Healthcare Provider Details

I. General information

NPI: 1710807912
Provider Name (Legal Business Name): NEKO HEALTH P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LAFAYETTE ST
NEW YORK NY
10012-2713
US

IV. Provider business mailing address

524 BROADWAY
NEW YORK NY
10012-4408
US

V. Phone/Fax

Practice location:
  • Phone: 646-793-4427
  • Fax:
Mailing address:
  • Phone: 646-793-4427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIA BERGENHEM
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 617-378-2474