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NPI 1922122928

NPI 1922122928 : LOIS BERMAN PH.D. : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1922122928
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    Entity Type          |    Individual 
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    Provider Name        |    LOIS BERMAN PH.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/17/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    177 E 87TH ST SUITE 502
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10128-2226
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    Country              |    US
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    Telephone            |    212-722-0250
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6910 108TH ST APT. 9F
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    City                 |    FOREST HILLS
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    State                |    NY
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    Zip                  |    11375-3852
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    Country              |    US
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    Telephone            |    718-263-3575
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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        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    08698
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    License Number State |    NY
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