Individual
SUSAN E BEREN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
948 48TH ST, BROOKLYN, NY 11219-2918
(718) 283-8020
(718) 635-7235
Mailing address
977 48TH ST, BROOKLYN, NY 11219-2919
(718) 283-8015
(718) 635-7235
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
013612
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013612-A15
HEALTH FIRST
NY
05
—
02265323
—
NY
01
—
149768
VALUE OPTIONS
NY
01
—
P2631218
OXFORD HEALTH PLANS
NY
Enumeration date
09/14/2005
Last updated
07/08/2007
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