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General NPI Number Information
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NPI Number | 1962850297
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Entity Type | Individual
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Provider Name | KIMBERLY NIX BERENS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/26/2016
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Last Update Date | 05/26/2016
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Provider Practice Location Address
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Address Line | 1020 LEXINGTON AVE
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City | NEW YORK
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State | NY
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Zip | 10021-4223
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Country | US
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Telephone | 212-861-1919
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Fax |
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Provider Business Mailing Address
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Address Line | 155 BIRCH HILL RD
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City | LOCUST VALLEY
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State | NY
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Zip | 11560-1803
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Country | US
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Telephone | 516-801-4817
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 000066-1
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License Number State | NY
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