Provider Demographics
NPI:1992954838
Name:BERRILL, NAFTALI G (PHD)
Entity type:Individual
Prefix:DR
First Name:NAFTALI
Middle Name:G
Last Name:BERRILL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 COURT ST
Mailing Address - Street 2:SUITE 1711
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11242-0103
Mailing Address - Country:US
Mailing Address - Phone:718-237-2127
Mailing Address - Fax:718-237-0831
Practice Address - Street 1:26 COURT ST
Practice Address - Street 2:SUITE 1711
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242-0103
Practice Address - Country:US
Practice Address - Phone:718-237-2127
Practice Address - Fax:718-237-0831
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009649103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist