Healthcare Provider Details

I. General information

NPI: 1457144818
Provider Name (Legal Business Name): MEGAN BERARDI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2025
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 FOREST AVE
STATEN ISLAND NY
10303-2127
US

IV. Provider business mailing address

1915 FOREST AVE
STATEN ISLAND NY
10303-2127
US

V. Phone/Fax

Practice location:
  • Phone: 718-981-3136
  • Fax: 718-981-6849
Mailing address:
  • Phone: 718-981-3136
  • Fax: 718-981-6849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number682467
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: