MEDICARE: MR. DAVID BERGSTEIN M.A., LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	004167	NY

General Provider Information

NPI Number	:	1134343445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID BERGSTEIN M.A., LMHC

Provider Business Mailing Address
First Line	:	347 5TH AVE RM 1502
Second Line	:	NEW YORK
City	:	NEW YORK
State	:	NY
Zip	:	10016-5049
Country	:	US
Telephone Number	:	212-532-2640
Fax Number	:

Provider Business Practice Location Address
First Line	:	347 5TH AVE RM 1502
Second Line	:	NEW YORK
City	:	NEW YORK
State	:	NY
Zip	:	10016-5049
Country	:	US
Telephone Number	:	212-532-2640
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	02/23/2016

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