Provider Demographics
NPI:1306176128
Name:BERMAN, ELISHEVA (MD)
Entity type:Individual
Prefix:DR
First Name:ELISHEVA
Middle Name:
Last Name:BERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 WATERS PL
Mailing Address - Street 2:DEPARTMENT OF FORENSICS
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2723
Mailing Address - Country:US
Mailing Address - Phone:718-862-4745
Mailing Address - Fax:
Practice Address - Street 1:3850 HUDSON MANOR TER
Practice Address - Street 2:APT 3AW
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1117
Practice Address - Country:US
Practice Address - Phone:718-862-4745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-29
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2546082084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry