Provider Demographics
NPI:1750764395
Name:BERMAN, CARYN
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:
Last Name:BERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CARYN
Other - Middle Name:
Other - Last Name:HORAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NYSCERTIFIED TEACHER
Mailing Address - Street 1:1 FOUNTAINBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-3001
Mailing Address - Country:US
Mailing Address - Phone:443-745-6760
Mailing Address - Fax:
Practice Address - Street 1:1 FOUNTAINBROOK AVE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-3001
Practice Address - Country:US
Practice Address - Phone:443-745-6760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator