Provider Demographics
NPI:1922399369
Name:BERK, BARBARA B (SLP)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:B
Last Name:BERK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 DORAL GREENS DR W
Mailing Address - Street 2:
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-5403
Mailing Address - Country:US
Mailing Address - Phone:914-939-1480
Mailing Address - Fax:
Practice Address - Street 1:41 DORAL GREENS DR W
Practice Address - Street 2:
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-5403
Practice Address - Country:US
Practice Address - Phone:914-939-1480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000052235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist