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Organization

ROBERTA BERNITT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PROF. ROBERTA BERNITT LCSW-R (OWNER)
(917) 558-5355
Entity
Organization

Contact information

Practice address
67-30 CLYDE ST. -SUITE A, NEW YORK, NY 11375
(917) 558-5355
(718) 520-0671
Mailing address
6730 CLYDE ST, SUITE 2A, FOREST HILLS, NY 11375-4055
(917) 558-5355
(718) 520-0671

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
R047904
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
145602
TX
Enumeration date
04/29/2008
Last updated
02/03/2017
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