Healthcare Provider Details

I. General information

NPI: 1104737865
Provider Name (Legal Business Name): MALKA BERKOWITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 PUGSLEY AVE
BRONX NY
10472-5114
US

IV. Provider business mailing address

1111 PUGSLEY AVE
BRONX NY
10472-5114
US

V. Phone/Fax

Practice location:
  • Phone: 332-900-8545
  • Fax: 332-900-8551
Mailing address:
  • Phone: 332-900-8545
  • Fax: 332-900-8551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number036509-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: