Provider Demographics
NPI:1902517402
Name:BERGER, ISRAEL (SWI)
Entity Type:Individual
Prefix:MR
First Name:ISRAEL
Middle Name:
Last Name:BERGER
Suffix:
Gender:M
Credentials:SWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 MIDDLETON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-8041
Mailing Address - Country:US
Mailing Address - Phone:718-930-8562
Mailing Address - Fax:
Practice Address - Street 1:762 WYTHE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-7831
Practice Address - Country:US
Practice Address - Phone:718-875-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical