Healthcare Provider Details

I. General information

NPI: 1396747861
Provider Name (Legal Business Name): GERALD MINKOWITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 01/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 49TH ST
BROOKLYN NY
11219-2922
US

IV. Provider business mailing address

2810 AVENUE K
BROOKLYN NY
11210-3746
US

V. Phone/Fax

Practice location:
  • Phone: 718-853-6433
  • Fax: 718-853-6449
Mailing address:
  • Phone: 718-853-6433
  • Fax: 718-853-6449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number176318
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number176318
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number176318
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: