Provider Demographics
NPI:1225181563
Name:BERRIOS, GISELLE E
Entity Type:Individual
Prefix:MISS
First Name:GISELLE
Middle Name:E
Last Name:BERRIOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 BEACH AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-3609
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:260 E 188TH ST
Practice Address - Street 2:260 EAST 188TH STREET
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5302
Practice Address - Country:US
Practice Address - Phone:718-960-0260
Practice Address - Fax:718-933-2502
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health