Provider Demographics
NPI:1598018616
Name:EHRENBERG, DARLENE BREGMAN (PHD)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:BREGMAN
Last Name:EHRENBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 5TH AVE
Mailing Address - Street 2:# 8D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1740
Mailing Address - Country:US
Mailing Address - Phone:212-288-5113
Mailing Address - Fax:212-288-1232
Practice Address - Street 1:952 5TH AVE
Practice Address - Street 2:# 8D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1740
Practice Address - Country:US
Practice Address - Phone:212-288-5113
Practice Address - Fax:212-288-1232
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPSY 003686103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical