Provider Demographics
NPI:1699004028
Name:BERZINS, PETER LUDIS
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:LUDIS
Last Name:BERZINS
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 1:498 TURNPIKE TPKE
Mailing Address - Street 2:
Mailing Address - City:POMPTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444-1930
Mailing Address - Country:US
Mailing Address - Phone:973-839-3060
Mailing Address - Fax:
Practice Address - Street 1:498 TURNPIKE TPKE
Practice Address - Street 2:
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-1930
Practice Address - Country:US
Practice Address - Phone:973-839-3060
Practice Address - Fax:973-907-2198
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018294-1103TC0700X
NJ35SI00480600103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical