Healthcare Provider Details

I. General information

NPI: 1568946986
Provider Name (Legal Business Name): BERLINE BORNO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2018
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 HEITMAN DR
SPRING VALLEY NY
10977-6063
US

IV. Provider business mailing address

130 HEITMAN DR
SPRING VALLEY NY
10977-6063
US

V. Phone/Fax

Practice location:
  • Phone: 845-300-5023
  • Fax:
Mailing address:
  • Phone: 845-300-5023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number129598
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: