=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427283944
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MYRIAM BERTHNELL JOSEPH ANP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/28/2009
-----------------------------------------------------
Last Update Date | 12/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 803 STERLING PL
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11216-3903
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-613-1700
-----------------------------------------------------
Fax | 718-363-1050
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 650 FULTON ST
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-596-9800
-----------------------------------------------------
Fax | 718-596-9812
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | F304982-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 579102-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------