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General NPI Number Information
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NPI Number | 1316455876
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Entity Type | Individual
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Provider Name | HILLARY REA BERCOVICI M.DIV., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 01/18/2018
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 8 SOUND SHORE DR STE 130
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City | GREENWICH
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State | CT
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Zip | 06830
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Country | US
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Telephone | 203-413-7804
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Fax |
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Provider Business Mailing Address
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Address Line | 8 SOUND SHORE DR STE 130
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City | GREENWICH
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State | CT
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Zip | 06830
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Country | US
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Telephone | 203-413-7804
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Fax |
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 3090
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License Number State |
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