Emile Tobias Berk, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

35SI00587100 Issued in NJ

Practice address

440 West St # 323
Fort Lee, NJ 07024-5028

Phone

(347) 879-0202

NPI assigned

Dec 18, 2017

Last updated

Dec 11, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1285140939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 WEST ST # 322",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245028",
            "telephone_number": "201-677-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 WEST ST # 323",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245028",
            "telephone_number": "347-879-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERK",
        "first_name": "EMILE",
        "middle_name": "TOBIAS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-18",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00587100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Fort Lee, NJ
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• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.