Provider Demographics
NPI:1205185949
Name:BIBERFELD, AVIVA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AVIVA
Middle Name:
Last Name:BIBERFELD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-5806
Mailing Address - Country:US
Mailing Address - Phone:718-437-6995
Mailing Address - Fax:718-437-6995
Practice Address - Street 1:685 E 5TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5806
Practice Address - Country:US
Practice Address - Phone:718-437-6995
Practice Address - Fax:718-437-6995
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010988-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical