Linda Susan Bergman, PH.D.
Individual provider Active NPI Clinical Psychologist · Centerport, NY
NPI 1073725545 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1073725545
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 004927-1 (NY)
- Practice address
- 83 Stony Hollow Road
Centerport, NY 11721-1750 - Phone
- (631) 754-4567
- Fax
- (631) 754-2707
- NPI assigned
- May 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004927 | NY | MD | Athletic Trainer |
| 004927-1 | NY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 004927-1 | NY | Yes |
Addresses
Primary practice location
83 Stony Hollow Road
Centerport, NY 11721-1750
Mailing address
83 Stony Hollow Road
Centerport, NY 11721-1750
Phone (631) 754-4567
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AF00096 | Other | NY | MDNY |
Other names
- Dr. Linda Susan Bergman-Zentman
Other providers in Centerport, NY
- Elizabeth Albano
- Anne Long, M.S., Inc
- Leea Nicole Betts
- John Michael Radman Bolger
- Christine Bonavita
- Susan M Bongiorno
- Susanne Bonsignore
All providers in Centerport, NY · Clinical Psychologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.