Provider Demographics
NPI:1285608927
Name:BERLINER, BRIAN K (OD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:K
Last Name:BERLINER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 LAKERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3962
Mailing Address - Country:US
Mailing Address - Phone:516-521-8984
Mailing Address - Fax:
Practice Address - Street 1:133 PLANDOME RD
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-2331
Practice Address - Country:US
Practice Address - Phone:855-295-4144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-16
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT004257-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP674719OtherOXFORD
NY0083795OtherGHI
NY0056259OtherAETNA
NY0074954OtherAETNA
NY0074954OtherAETNA