Provider Demographics
NPI:1376819946
Name:BERRY, STANLEY V (CHEF)
Entity type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:V
Last Name:BERRY
Suffix:
Gender:M
Credentials:CHEF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3352 WHEATCROFT DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-6159
Mailing Address - Country:US
Mailing Address - Phone:513-376-7158
Mailing Address - Fax:
Practice Address - Street 1:3352 WHEATCROFT DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-6159
Practice Address - Country:US
Practice Address - Phone:513-376-7158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes132700000XDietary & Nutritional Service ProvidersDietary Manager