Healthcare Provider Details

I. General information

NPI: 1477970689
Provider Name (Legal Business Name): CHAYA MEIRA RIEDER- BEREN M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 03/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HAMASPIK WAY
MONROE NY
10950-8452
US

IV. Provider business mailing address

23 WITZEL CT
MONSEY NY
10952-7833
US

V. Phone/Fax

Practice location:
  • Phone: 845-774-8400
  • Fax:
Mailing address:
  • Phone: 646-592-0112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: