Individual provider Active NPI

Deborah Berry, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1629228531
Registry record updated Sep 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
009988-1 Issued in NY
Practice address
347 5TH Ave
Suite 1007
New York, NY 10016-5010
Phone
(212) 252-9362
NPI assigned
Sep 27, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 009988-1 NY Primary

Addresses

Primary practice location

347 5TH Ave
Suite 1007
New York, NY 10016-5010

Mailing address

347 5TH Ave
Suite 1007
New York, NY 10016-5010
Phone (212) 252-9362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040329000157 NY Practitioner - Clinical Psychologist 1759273352 Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

966 Park PL
Brooklyn, NY 11213-1803
Phone (212) 252-9362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
009988-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1222473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222473600000",
    "number": "1629228531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 5TH AVE",
            "address_2": "SUITE 1007",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165010",
            "telephone_number": "212-252-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 5TH AVE",
            "address_2": "SUITE 1007",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165010",
            "telephone_number": "212-252-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "DEBORAH",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-27",
        "last_updated": "2008-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "009988-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.