Karen Rose Bergonio, DDS
Individual provider Active NPI Dentist · Nanuet, NY
NPI 1104049295 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104049295
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 051375 (NY)
- Practice address
- 161 Main St
Nanuet, NY 10954-2878 - Phone
- (845) 623-0710
- Fax
- (845) 215-5567
- NPI assigned
- Apr 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051375 | NY | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 051375 | NY | Yes |
Addresses
Primary practice location
161 Main St
Nanuet, NY 10954-2878
Mailing address
161 Main St
Nanuet, NY 10954-2878
Phone (845) 623-0710
Other names
- Dr. Karen Rose Viray
Other providers in Nanuet, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.