Provider Demographics
NPI:1174532113
Name:BERKOWITZ, KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:
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 1:425 MADISON AVE
Mailing Address - Street 2:FL 11
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1134
Mailing Address - Country:US
Mailing Address - Phone:212-459-1700
Mailing Address - Fax:212-459-1727
Practice Address - Street 1:7 W 51ST ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-6910
Practice Address - Country:US
Practice Address - Phone:212-459-1700
Practice Address - Fax:212-459-1727
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204549207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY34N871Medicare PIN
NYG69183Medicare UPIN
NY34N87EW041Medicare PIN