Healthcare Provider Details

I. General information

NPI: 1750251443
Provider Name (Legal Business Name): CHAVA BERKOWITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 LAWRENCE AVE
LAWRENCE NY
11559-1440
US

IV. Provider business mailing address

125 LAWRENCE AVE
LAWRENCE NY
11559-1440
US

V. Phone/Fax

Practice location:
  • Phone: 646-228-1247
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number359576
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number918480
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: