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General NPI Number Information
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NPI Number | 1902358526
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Entity Type | Organization
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Legal Business Name | OCEAN HEALTH INITIATIVES, INC.
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Dates
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Enumeration Date | 10/31/2016
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Last Update Date | 10/31/2016
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Provider Practice Location Address
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Address Line | 101 2ND ST
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City | LAKEWOOD
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State | NJ
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Zip | 08701-3324
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Country | US
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Telephone | 732-363-6655
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Fax |
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Provider Business Mailing Address
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Address Line | 101 2ND ST
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City | LAKEWOOD
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State | NJ
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Zip | 08701-3324
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Country | US
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Telephone | 732-363-6655
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Fax |
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Authorized Official
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Title or Position | C.E.O.
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Name | DR. THERESA BERGER
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Credential | M.D.
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Telephone | 732-719-9015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ00679600
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License Number State | NJ
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