MEDICARE: MRS. SARAH BERGER LCSW

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	1041C0700X	Clinical Social Worker	R056024	NY

General Provider Information

NPI Number	:	1477689271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH BERGER LCSW

Provider Business Mailing Address
First Line	:	563 BARNARD AVE
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-2707
Country	:	US
Telephone Number	:	516-569-3909
Fax Number	:	516-792-6631

Provider Business Practice Location Address
First Line	:	1226 W BROADWAY
Second Line	:
City	:	HEWLETT
State	:	NY
Zip	:	11557-1923
Country	:	US
Telephone Number	:	516-503-1701
Fax Number	:

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	07/08/2007

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