Provider Demographics
NPI:1689882409
Name:ERSES, BIRSEN (PHD,LP)
Entity Type:Individual
Prefix:
First Name:BIRSEN
Middle Name:
Last Name:ERSES
Suffix:
Gender:F
Credentials:PHD,LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 E 94TH ST
Mailing Address - Street 2:#6F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0709
Mailing Address - Country:US
Mailing Address - Phone:212-410-0621
Mailing Address - Fax:
Practice Address - Street 1:40 E 94TH ST
Practice Address - Street 2:#6F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0709
Practice Address - Country:US
Practice Address - Phone:212-410-0621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000225102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst