MEDICARE: DR. BRENDA L BIERDEMAN PSY.D.

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
1	103TC0700X	Clinical Psychologist	012329-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000523807001	OTHER	NY	BLUE CROSS BLUE SHIELD
2	6892936	OTHER		EMPIRE/GHI/VALUE OPTIONS
3	7013327	OTHER		AETNA
4	F010012329	OTHER	NY	BLUE CHOICE
5	040426031011	OTHER		FIDELIS
6	103226FC	OTHER		PREFERRED CARE
7	6107851	OTHER		INDEPENDENT HEALTH
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	S12329-9B	OTHER		WOKER'S COMP

General Provider Information

NPI Number	:	1376549808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRENDA L BIERDEMAN PSY.D.

Provider Business Mailing Address
First Line	:	27 S PLATT ST
Second Line	:
City	:	ALBION
State	:	NY
Zip	:	14411-1431
Country	:	US
Telephone Number	:	585-589-2315
Fax Number	:	585-589-1036

Provider Business Practice Location Address
First Line	:	27 S PLATT ST
Second Line	:
City	:	ALBION
State	:	NY
Zip	:	14411-1431
Country	:	US
Telephone Number	:	585-589-2315
Fax Number	:	585-589-1036

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	09/14/2010

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