Individual
DR. JANICE BLAKE BERGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
55 OLD TURNPIKE RD, SUITE 601, NANUET, NY 10954-2461
(845) 627-3413
(212) 567-9476
Mailing address
20 ROSLYN LN, NEW CITY, NY 10956-3616
(845) 638-4926
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
007741
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02206444
—
NY
01
—
142513000
MAGELLAN
NY
01
—
5065663
AETNA
NY
01
—
61-32223
UNITED BEHAVIORAL HEALTH
NY
01
—
6802403
VALUEOPTIONS/GHI
NY
01
—
V65662
EMPIRE BCBS
NY
Enumeration date
10/25/2006
Last updated
07/08/2007
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