Berg, Bradley

Berg, Bradley is an individual health care provider with primary practice located at 11 Crum Elbow Road Family Practice Center Of Hyde Park, Hyde Park NY 12538. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Berg, Bradley can be contacted via phone (845) 229-1020.

Contact Information

Primary practice address
11 Crum Elbow Road Family Practice Center Of Hyde Park Hyde Park NY 12538
Phone: (845) 229-1020
Fax: (845) 229-2005
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X RO36212-1 New York

Profile Details

NPI number 1609975531
LBN Legal business name Berg, Bradley
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1609975531 NPPES
New York MEDICAID 00733871
New York Other W08221

Popular Providers