| Doctor Name: | DR. ELLEN RAYNES BERMAN |
| NPI Number: | 1013073147 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 009609-1 |
| Business Practice Address: | 123 Macgregor Dr Stamford, CT - 069021409 |
| Business Phone Number: | 2039618818 |
| Business Fax Number: | |
| Mailing Address: | 123 Macgregor Dr, STAMFORD |
| State: | CT |
| Postal Code: | 069021409 |
| Phone Number: | 2039730181 |
| Fax Number: | |
| NPI Enumeration Date: | 01/01/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 009609-1 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |