Active NPI
Abbey Lynn Berg, PH.D.
- Audiologist
- New York, NY
National Provider Identifier
1104967249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 000494-1
- Practice address
- 3959 Broadway
Room 503 Central
New York, NY 10032-1559 - Phone
- (212) 305-0656
- Fax
- (212) 305-6142
- NPI assigned
- Feb 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 000494-1 | NY | Primary |
Addresses
Primary practice location
3959 Broadway
Room 503 Central
New York, NY 10032-1559
Mailing address
245 W 107TH St
Apartment 2F
New York, NY 10025-3049
Phone (212) 866-6533
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000494-1 | NY | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104967249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 W 107TH ST",
"address_2": "APARTMENT 2F",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100253049",
"telephone_number": "212-866-6533",
"fax_number": "212-866-8638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3959 BROADWAY",
"address_2": "ROOM 503 CENTRAL",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100321559",
"telephone_number": "212-305-0656",
"fax_number": "212-305-6142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERG",
"first_name": "ABBEY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NY",
"license": "000494-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.