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General NPI Number Information
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NPI Number | 1407133341
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Entity Type | Individual
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Provider Name | DIANA MEJIAS-BERGMEIER PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 11/07/2011
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 1620 ROUTE 22
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City | BREWSTER
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State | NY
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Zip | 10509-4051
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Country | US
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Telephone | 845-278-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 22 DEER RUN CT
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City | CARMEL
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State | NY
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Zip | 10512-3629
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Country | US
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Telephone | 203-794-4193
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 018183
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License Number State | NY
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