Provider Demographics
NPI:1629391008
Name:POBERESKY, BERTA L (DR MS/ MASTER SCIEN)
Entity Type:Individual
Prefix:MRS
First Name:BERTA
Middle Name:L
Last Name:POBERESKY
Suffix:
Gender:F
Credentials:DR MS/ MASTER SCIEN
Other - Prefix:
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Mailing Address - Street 1:PO BOX 286382
Mailing Address - Street 2:345 E 94 ST APT 3A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128
Mailing Address - Country:US
Mailing Address - Phone:212-933-1758
Mailing Address - Fax:212-842-1082
Practice Address - Street 1:345 E 94 ST
Practice Address - Street 2:APT 3A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128
Practice Address - Country:US
Practice Address - Phone:646-717-3182
Practice Address - Fax:212-842-1082
Is Sole Proprietor?:No
Enumeration Date:2010-03-12
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY002581171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist