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General NPI Number Information
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NPI Number | 1104967249
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Entity Type | Individual
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Provider Name | ABBEY LYNN BERG PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3959 BROADWAY ROOM 503 CENTRAL
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City | NEW YORK
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State | NY
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Zip | 10032-1559
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Country | US
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Telephone | 212-305-0656
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Fax | 212-305-6142
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Provider Business Mailing Address
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Address Line | 245 W 107TH ST APARTMENT 2F
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City | NEW YORK
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State | NY
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Zip | 10025-3049
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Country | US
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Telephone | 212-866-6533
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Fax | 212-866-8638
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 000494-1
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License Number State | NY
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