Healthcare Provider Details

I. General information

NPI: 1609014257
Provider Name (Legal Business Name): AMY BETH BERKMAN O.T.R.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2009
Last Update Date: 02/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1049-38 ST STEP BY STEP
BROOKLYN NY
11219
US

IV. Provider business mailing address

122 KANE ST
BROOKLYN NY
11231-3013
US

V. Phone/Fax

Practice location:
  • Phone: 917-774-3077
  • Fax:
Mailing address:
  • Phone: 917-774-3077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number005972-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: