Provider Demographics
NPI:1447467832
Name:BERSHATSKY, CHARLES (PHD, CSW, PC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:BERSHATSKY
Suffix:
Gender:M
Credentials:PHD, CSW, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 CENTRAL PARK W # 1AS
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6038
Mailing Address - Country:US
Mailing Address - Phone:212-496-8989
Mailing Address - Fax:212-724-1822
Practice Address - Street 1:239 CENTRAL PARK W # 1AS
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6038
Practice Address - Country:US
Practice Address - Phone:212-496-8989
Practice Address - Fax:212-724-1822
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR029741-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical