Provider Demographics
NPI:1548390834
Name:TALMATCH, BERNICE
Entity Type:Individual
Prefix:MS
First Name:BERNICE
Middle Name:
Last Name:TALMATCH
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 1:7 SUSQUEHANNA AVE
Mailing Address - Street 2:GREAT NECK
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:11021
Mailing Address - Country:US
Mailing Address - Phone:516-466-5226
Mailing Address - Fax:
Practice Address - Street 1:10326 68 RD
Practice Address - Street 2:ADVANCED CENTER FOR PSYCHOTHERAPY
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-261-3330
Practice Address - Fax:718-897-0095
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR02003711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical