Marie Anne Berberich, R.N., B.S.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

635530-1 Issued in NY

Practice address

11 Walnut Road
Hickory Hill Estates
Pleasant Valley, NY 12569

Phone

(845) 635-1778

NPI assigned

Nov 17, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Marie Anne Ketcham Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1740557966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 WALNUT ROAD",
            "address_2": "PO BOX 1228",
            "city": "PLEASANT VALLEY",
            "state": "NY",
            "postal_code": "125691228",
            "telephone_number": "845-635-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 WALNUT ROAD",
            "address_2": "HICKORY HILL ESTATES",
            "city": "PLEASANT VALLEY",
            "state": "NY",
            "postal_code": "12569",
            "telephone_number": "845-635-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERBERICH",
        "first_name": "MARIE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "R.N., B.S.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-17",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "635530-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "KETCHAM",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Nurse in Pleasant Valley, NY
• Providers in Pleasant Valley, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.