Provider Demographics
NPI:1124094594
Name:BERKOWITZ, ISRAEL S (MD)
Entity type:Individual
Prefix:DR
First Name:ISRAEL
Middle Name:S
Last Name:BERKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 E 59TH ST
Mailing Address - Street 2:SUITE8A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1304
Mailing Address - Country:US
Mailing Address - Phone:212-772-3363
Mailing Address - Fax:212-434-6169
Practice Address - Street 1:110 E 59TH ST
Practice Address - Street 2:SUITE8A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1304
Practice Address - Country:US
Practice Address - Phone:212-772-3363
Practice Address - Fax:212-434-6169
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150378207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY66D84ZVRW1Medicare PIN
NY06019GMedicare PIN