Healthcare Provider Details

I. General information

NPI: 1790906121
Provider Name (Legal Business Name): GISELA GERTRUD HOFFMANN BERKSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 LEXINGTON AVE SUITE P 2
NEW YORK NY
10010-5517
US

IV. Provider business mailing address

7 LEXINGTON AVE SUITE P 2
NEW YORK NY
10010-5517
US

V. Phone/Fax

Practice location:
  • Phone: 212-674-7445
  • Fax:
Mailing address:
  • Phone: 212-674-7445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR026402-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: