| Doctor Name: | MR. ROY WILLIAM BERMAN |
| NPI Number: | 1013134766 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ACSW |
| License Number: | RO17615 |
| Business Practice Address: | 900 Walt Whitman Rd Suite Ll7 Melville, NY - 117472293 |
| Business Phone Number: | 6314251954 |
| Business Fax Number: | 6314255954 |
| Mailing Address: | 96 Mobrey Ln, SMITHTOWN |
| State: | NY |
| Postal Code: | 117874236 |
| Phone Number: | 6316707368 |
| Fax Number: | 6314255954 |
| NPI Enumeration Date: | 04/20/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | RO17615 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |