MEDICARE: MS. NAOMI BERGER

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	235Z00000X	Speech-Language Pathologist	14025553	NY

General Provider Information

NPI Number	:	1639480601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NAOMI BERGER

Provider Business Mailing Address
First Line	:	949 E 19TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-3804
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	949 E 19TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-3804
Country	:	US
Telephone Number	:	917-626-4075
Fax Number	:

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

Provider Enumeration Date	:	06/24/2010
Last Update Date	:	06/24/2010

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Directions to “ MS. NAOMI BERGER ” Practice Location

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