Healthcare Provider Details

I. General information

NPI: 1255244166
Provider Name (Legal Business Name): BREYANKA SEERAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1887 RICHMOND AVE
STATEN ISLAND NY
10314-3939
US

IV. Provider business mailing address

81 CROWN AVE
STATEN ISLAND NY
10312-2349
US

V. Phone/Fax

Practice location:
  • Phone: 718-698-1300
  • Fax:
Mailing address:
  • Phone: 917-716-5124
  • 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: