Provider Demographics
NPI:1003008780
Name:BERGMAN, MAJA KATARINA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MAJA
Middle Name:KATARINA
Last Name:BERGMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W 146TH ST APT 52
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-0708
Mailing Address - Country:US
Mailing Address - Phone:917-723-0619
Mailing Address - Fax:510-601-4002
Practice Address - Street 1:600 W 146TH ST APT 52
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-0708
Practice Address - Country:US
Practice Address - Phone:917-723-0619
Practice Address - Fax:510-601-4002
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026159103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical