Provider Demographics
NPI:1326845926
Name:BERTE, KAFONO ABDOUL
Entity type:Individual
Prefix:
First Name:KAFONO
Middle Name:ABDOUL
Last Name:BERTE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 PARK CREST DR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68133-4449
Mailing Address - Country:US
Mailing Address - Phone:929-288-9838
Mailing Address - Fax:
Practice Address - Street 1:2204 PARK CREST DR
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68133-4449
Practice Address - Country:US
Practice Address - Phone:929-288-9838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor