Provider Demographics
NPI:1144376773
Name:RIVERA-BERGER, BARBARA L
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:L
Last Name:RIVERA-BERGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:L
Other - Last Name:BERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCAT, CASAC
Mailing Address - Street 1:2908 31ST AVE APT E7
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-2825
Mailing Address - Country:US
Mailing Address - Phone:718-918-4486
Mailing Address - Fax:
Practice Address - Street 1:1400 PELHAM PARKWAY SOUTH, BUILDING 5
Practice Address - Street 2:JACOBI MEDICAL CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-918-4486
Practice Address - Fax:718-918-4733
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18349101YA0400X
NY000115103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist