| Doctor Name: | DR. NICOLE BERMAN |
| NPI Number: | 1235201906 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 016931 |
| Business Practice Address: | 80 Glen Head Rd Suite 200 Glen Head, NY - 115451933 |
| Business Phone Number: | 5165865860 |
| Business Fax Number: | 5165865861 |
| Mailing Address: | 1007 Glen Cove Ave, Suite 2 Lower Level GLEN HEAD |
| State: | NY |
| Postal Code: | 115451589 |
| Phone Number: | 5165865860 |
| Fax Number: | 5165865861 |
| NPI Enumeration Date: | 11/15/2006 |
| NPI Last Update Date: | 07/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 016931 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |