MEDICARE: DR. BEVERLY WINIKOFF M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0901X	Public Health & General Preventive Medicine Physician	121282	NY

General Provider Information

NPI Number	:	1144480831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BEVERLY WINIKOFF M.D.

Provider Business Mailing Address
First Line	:	15 E 26TH ST
Second Line	:	801
City	:	NEW YORK
State	:	NY
Zip	:	10010-1505
Country	:	US
Telephone Number	:	212-448-1230
Fax Number	:	212-448-1260

Provider Business Practice Location Address
First Line	:	15 E 26TH ST
Second Line	:	801
City	:	NEW YORK
State	:	NY
Zip	:	10010-1505
Country	:	US
Telephone Number	:	212-448-1230
Fax Number	:	212-448-1260

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2008
Last Update Date	:	06/16/2008

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