DARA BERGEN (NPI# 1174554703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174554703 |
| Entity Type | Individual |
| Full Name | DARA BERGEN |
| Credential | RD |
| Practice Address |
11241 Queens Blvd Suite 100 Forest Hills NY 11375-5564 |
| Practice Telephone | 7185440770 |
| Practice Fax Number | 7182615522 |
| Mailing Telephone | 7185440770 |
| Mailing Fax Number | 7182612262 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2009-02-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 005450 | NY | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | ATLANTIS | BD5450 | 01 |
| Street Address |
11241 QUEENS BLVD SUITE 100 |
| City | FOREST HILLS |
| State | NY |
| Zip Code | 11375-5564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851391692 | Igor Israel | Internal Medicine | 11241 Queens Blvd, Suite Llb, Forest Hills, NY 11375-7475 | 2005-07-22 |
| 1760959241 | Istam Mazal Fuzailov | Occupational Therapist | 11241 Queens Blvd, Forest Hills, NY 11375-7475 | 2018-11-01 |
| 1538465034 | Katherine Beth Sapadin | Psychologist | 11241 Queens Blvd, 100, Forest Hills, NY 11375-7475 | 2011-01-31 |
| 1740436393 | Robert Bergen | Social Worker | 11241 Queens Blvd, Suite 203, Forest Hills, NY 11375-5564 | 2008-08-14 |
| 1699936088 | Diagnostic & Interventional Cardiac Svcs, PC | Nuclear Medicine | 11241 Queens Blvd, Suite Lla, Forest Hills, NY 11375-5564 | 2008-06-19 |
| 1538336136 | Gramercy Cardiac Diagnostic Services, P.C. | Nuclear Medicine | 11241 Queens Blvd, Suite Lla, Forest Hills, NY 11375-5564 | 2008-05-13 |
| 1730232000 | Luba Alexandra Roytburd | Psychologist | 11241 Queens Blvd, Suite 100, Forest Hills, NY 11375-7475 | 2007-01-19 |
| 1063458560 | I & R Medical Services PC | General Practice | 11241 Queens Blvd, Suite Llb, Forest Hills, NY 11375-7475 | 2006-06-22 |
| 1528068368 | Roza Israel | Internal Medicine | 11241 Queens Blvd, Suite Llb, Forest Hills, NY 11375-7475 | 2005-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932709623 | Nicole Ficano | Counselor | 102-02 66th Road, Forest Hills, NY 11375 | 2020-10-30 |
| 1396342473 | One Stop Senior Day Care Inc | Clinic/Center | 108-10 72nd Ave 2fl, Forest Hills, NY 11375 | 2020-10-02 |
| 1063029023 | Prohealth Care Associates, LLP | Occupational Therapist | 118-35 Queens Boulevard, Suite 1550, Forest Hills, NY 11375 | 2020-09-24 |
| 1659909398 | Lindsay Stemke | Student in an Organized Health Care Education/Training Program | 102-01 66th Rd., Forest Hills, NY 11375 | 2020-03-30 |
| 1609409887 | Yesodot, Inc | Clinic/Center | 110-06 69th Ave, Forest Hills, NY 11375 | 2020-02-17 |
| 1831744945 | Darius Douglas | Counselor | Bleuler Psychotherapy Center 104-70 Queens Blvd, Suite 500, Forest Hills, NY 11375 | 2019-08-06 |
| 1598329914 | Jane Rochelle Pahang | Physical Therapist | 116-21 Queens Blvd, Forest Hills, NY 11375 | 2019-05-01 |
| 1558828939 | Natalie Koptyev | Pharmacist | 108-14 68th Drive, Forest Hills, NY 11375 | 2019-02-21 |
| 1043782014 | Magdalena Lekic Salameh | Behavioral Analyst | 67-29 Kessel Street, Forest Hills, NY 11375 | 2018-12-31 |
| 1861960031 | Bertine Sylvie Alectine | Specialist | 108-18 Queens Blvd, 5th Floor, Suite 4a, Forest Hills, NY 11375 | 2018-11-06 |
| Find all providers in zip 11375 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932661345 | Mabel Wu | Dietitian, Registered | 6981 108th St Apt 4f, Forest Hills, NY 11375-4339 | 2019-04-03 |
| 1124515622 | Michelle Routhenstein | Dietitian, Registered | 6911 Yellowstone Blvd Apt A67, Forest Hills, NY 11375-3724 | 2018-04-19 |
| 1912346511 | Kelly Krikhely | Dietitian, Registered | 111-17a Queens Blvd, Forest Hills, NY 11375-5553 | 2013-06-18 |
| 1588908875 | Diana Stephany Alberti | Dietitian, Registered | 112-41 Queens Blvd., Suite 100, Forest Hills, NY 11375 | 2012-11-27 |
| 1700153616 | Avital Greenbaum | Dietitian, Registered | 10225 67th Dr, Apt 1g, Forest Hills, NY 11375-2860 | 2011-11-20 |
| 1174731152 | Therapeutic Early Intervention Services, Lp. | Dietitian, Registered | 3 Parkway Center East, 2020 Ardmore Blvd, Suite 295, Forest Hills, PA 15221-4638 | 2007-05-21 |
| 1588732341 | Lorena Drago | Dietitian, Registered | 7140 112th St Apt 404, Forest Hills, NY 11375-4624 | 2006-12-01 |
| 1689205072 | Bina Goykadosh | Dietitian, Registered | 11241 Queens Blvd Ste 100, Forest Hills, NY 11375-5564 | 2020-02-04 |
| 1053780569 | Alissa Lewis | Dietitian, Registered | 10915 Queens Blvd, 2g, Forest Hills, NY 11375-5482 | 2015-09-15 |
| 1285036731 | Miriam Frucht | Dietitian, Registered | 10240 67th Rd, Apt 1t, Forest Hills, NY 11375-2663 | 2014-09-16 |
| Find all providers in FOREST HILLS | ||||
| City | FOREST HILLS |
| Zip Code | 11375 |
Please comment or provide details below to improve the information on DARA BERGEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.