Individual provider Active NPI

Civia Yenty Berman, MS,TSHH

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1669736369
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
1413 E 12TH St
Brooklyn, NY 11230-6605
Phone
(347) 410-3633
NPI assigned
Jun 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

1413 E 12TH St
Brooklyn, NY 11230-6605

Mailing address

1413 E 12TH St
Brooklyn, NY 11230-6605
Phone (347) 410-3633

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
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1669736369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 E 12TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306605",
            "telephone_number": "347-410-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 E 12TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306605",
            "telephone_number": "347-410-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "CIVIA",
        "middle_name": "YENTY",
        "name_prefix": "Mrs.",
        "credential": "MS,TSHH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.