Individual
MR. BRADLEY BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
11 CRUM ELBOW ROAD, FAMILY PRACTICE CENTER OF HYDE PARK, HYDE PARK, NY 12538
(845) 229-1020
(845) 229-2005
Mailing address
11 CRUM ELBOW ROAD, FAMILY PRACTICE CENTER OF HYDE PARK, HYDE PARK, NY 12538
(845) 229-1020
(845) 229-2005
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
RO36212-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00733871
—
NY
01
—
W08221
GROUP #
NY
Enumeration date
09/21/2006
Last updated
07/08/2007
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