Provider Demographics
NPI:1568790038
Name:BERGER, GITTY (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:GITTY
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 PARKER BLVD
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1450
Mailing Address - Country:US
Mailing Address - Phone:845-517-2503
Mailing Address - Fax:
Practice Address - Street 1:1 DINEV RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-6487
Practice Address - Country:US
Practice Address - Phone:845-782-7510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-22
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015060-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1568790038OtherSPEECH LANGUAGE PATHOLOGIST