MEDICARE: DR. GERALD MINKOWITZ 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	176318	NY
2	207ZC0500X	Cytopathology Physician	176318	NY
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	176318	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	176318	OTHER	NY	NYS LICENSE

General Provider Information

NPI Number	:	1396747861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERALD MINKOWITZ M.D.

Provider Business Mailing Address
First Line	:	2810 AVENUE K
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-3746
Country	:	US
Telephone Number	:	718-853-6433
Fax Number	:	718-853-6449

Provider Business Practice Location Address
First Line	:	904 49TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-2922
Country	:	US
Telephone Number	:	718-853-6433
Fax Number	:	718-853-6449

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	01/27/2011

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