Provider Demographics
NPI:1083023154
Name:BERKOVIC, JOSEPH
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:BERKOVIC
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:978 ROUTE 45 STE 108
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3512
Mailing Address - Country:US
Mailing Address - Phone:845-356-1534
Mailing Address - Fax:845-579-7209
Practice Address - Street 1:978 ROUTE 45 STE 108
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3512
Practice Address - Country:US
Practice Address - Phone:845-356-1534
Practice Address - Fax:845-579-7209
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP93183213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery