Provider Demographics
NPI:1255411930
Name:NIGHTINGALE, BERYL ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:BERYL
Middle Name:ANN
Last Name:NIGHTINGALE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 COURT ST STE 800
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4414
Mailing Address - Country:US
Mailing Address - Phone:347-495-3624
Mailing Address - Fax:
Practice Address - Street 1:44 COURT ST
Practice Address - Street 2:SUITE 800
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242
Practice Address - Country:US
Practice Address - Phone:347-495-3624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015848103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist