Provider Demographics
NPI:1255548723
Name:BERGER, BARBARA (MS, PA, PC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:MS, PA, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 E 10TH ST
Mailing Address - Street 2:#6
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-5411
Mailing Address - Country:US
Mailing Address - Phone:212-260-1206
Mailing Address - Fax:
Practice Address - Street 1:594 BROADWAY
Practice Address - Street 2:SUITE 1213
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3233
Practice Address - Country:US
Practice Address - Phone:212-260-1206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000002-2102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst