Provider Demographics
NPI:1336806553
Name:BERGSON, ESTHER (RDN)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:BERGSON
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2427 EATON RD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-4336
Mailing Address - Country:US
Mailing Address - Phone:216-225-5103
Mailing Address - Fax:
Practice Address - Street 1:1025 S TRIMBLE RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3427
Practice Address - Country:US
Practice Address - Phone:216-785-6364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-22
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered