Provider Demographics
NPI:1396747861
Name:MINKOWITZ, GERALD (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:
Last Name:MINKOWITZ
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 1:2810 AVENUE K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-3746
Mailing Address - Country:US
Mailing Address - Phone:718-853-6433
Mailing Address - Fax:718-853-6449
Practice Address - Street 1:904 49TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2922
Practice Address - Country:US
Practice Address - Phone:718-853-6433
Practice Address - Fax:718-853-6449
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176318207RE0101X, 207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY176318OtherNYS LICENSE
NY33H432Medicare ID - Type Unspecified
NYF48308Medicare UPIN