Provider Demographics
NPI:1619353794
Name:BERNZWEIG, AMY DAWB (MS, SPED, ED)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:DAWB
Last Name:BERNZWEIG
Suffix:
Gender:F
Credentials:MS, SPED, ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HORIZON DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-4409
Mailing Address - Country:US
Mailing Address - Phone:631-421-2419
Mailing Address - Fax:
Practice Address - Street 1:11 HORIZON DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-4409
Practice Address - Country:US
Practice Address - Phone:631-421-2419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY893081174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist