Provider Demographics
NPI:1285955641
Name:BERKLEY, SETH F (MD)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:F
Last Name:BERKLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MIDDAGH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1340
Mailing Address - Country:US
Mailing Address - Phone:212-847-1100
Mailing Address - Fax:
Practice Address - Street 1:110 WILLIAM STREET
Practice Address - Street 2:C/O IAVI
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038
Practice Address - Country:US
Practice Address - Phone:212-847-1100
Practice Address - Fax:212-847-1101
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY181896207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine