Provider Demographics
NPI:1811100456
Name:BERRY, KAREN JUDITH (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:JUDITH
Last Name:BERRY
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 1:14 UNION CORNERS RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-2520
Mailing Address - Country:US
Mailing Address - Phone:845-987-9919
Mailing Address - Fax:
Practice Address - Street 1:14 UNION CORNERS RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-2520
Practice Address - Country:US
Practice Address - Phone:845-987-9919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10635103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist