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General NPI Number Information
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NPI Number | 1871180034
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Entity Type | Organization
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Legal Business Name | BERNILK WELL CARE
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Dates
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Enumeration Date | 12/22/2020
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 192 CYPRESS DR
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City | COLONIA
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State | NJ
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Zip | 07067-1507
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Country | US
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Telephone | 973-600-6509
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Fax |
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Provider Business Mailing Address
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Address Line | 192 CYPRESS DR
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City | COLONIA
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State | NJ
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Zip | 07067-1507
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Country | US
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Telephone | 973-600-6509
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARLINE ARCHILLE
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Credential | NP
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Telephone | 973-600-6509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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