Provider Demographics
NPI:1568907699
Name:BERGER, YESHIA
Entity Type:Individual
Prefix:
First Name:YESHIA
Middle Name:
Last Name:BERGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 TEVERYA WAY UNIT 102
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-5492
Mailing Address - Country:US
Mailing Address - Phone:845-206-9142
Mailing Address - Fax:
Practice Address - Street 1:3 TEVERYA WAY UNIT 102
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-5492
Practice Address - Country:US
Practice Address - Phone:845-206-9142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist