Provider Demographics
NPI:1871654533
Name:BERGER, ROCHELLE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ROCHELLE
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 LYNCREST RD
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-6705
Mailing Address - Country:US
Mailing Address - Phone:914-739-2152
Mailing Address - Fax:914-739-2152
Practice Address - Street 1:5 LYNCREST RD
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-6705
Practice Address - Country:US
Practice Address - Phone:914-739-2152
Practice Address - Fax:914-739-2152
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3227235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5253440Medicare UPIN
NYWS888Medicare UPIN
NY'00000082766Medicare UPIN
NY504512Medicare UPIN
NYWS-0001018Medicare UPIN
NYM16961Medicare UPIN