MEDICARE: DR JAY B BERKOWITZ DC PC

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	261Q00000X	Clinic/Center	0104000609	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790844900
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR JAY B BERKOWITZ DC PC

Provider Business Mailing Address
First Line	:	4867 BAXTER RD
Second Line	:	SUITE 107
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-4469
Country	:	US
Telephone Number	:	757-497-1555
Fax Number	:	757-497-2715

Provider Business Practice Location Address
First Line	:	4867 BAXTER RD
Second Line	:	SUITE 107
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-4469
Country	:	US
Telephone Number	:	757-497-1555
Fax Number	:	757-497-2715

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAY B BERKOWITZ
Credential	:	D.C.
Telephone Number	:	757-497-1555

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	02/07/2022

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