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NPI Code Detail

MEDICARE: JAY H. BERK, PH.D., INC.

MEDICARE: JAY H. BERK, PH.D., INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist4737OH

General Provider Information

NPI Number : 1316261381
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAY H. BERK, PH.D., INC.
Provider Business Mailing Address
First Line : 23293 COMMERCE PARK
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-5808
Country : US
Telephone Number : 216-292-7170
Fax Number : 216-292-7182
Provider Business Practice Location Address
First Line : 23293 COMMERCE PARK
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-5808
Country : US
Telephone Number : 216-292-7170
Fax Number : 216-292-7182
Authorized Official
Title or Position : PRESIDENT
Name : JAY HOWARD BERK
Credential : PH.D.
Telephone Number : 216-292-7170
Provider Enumeration Date : 03/19/2010
Last Update Date : 12/04/2018

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