Healthcare Provider Details

I. General information

NPI: 1285608927
Provider Name (Legal Business Name): BRIAN K BERLINER O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 PLANDOME RD
MANHASSET NY
11030-2331
US

IV. Provider business mailing address

16 LAKERIDGE DR
HUNTINGTON NY
11743-3962
US

V. Phone/Fax

Practice location:
  • Phone: 855-295-4144
  • Fax:
Mailing address:
  • Phone: 516-521-8984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberVUT004257-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierP674719
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerOXFORD
# 2
Identifier0083795
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerGHI
# 3
Identifier0056259
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerAETNA
# 4
Identifier0074954
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerAETNA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: