Healthcare Provider Details

I. General information

NPI: 1740218171
Provider Name (Legal Business Name): RICHARD ALAN BERLINER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 10/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

359 E MAIN ST SUITE 2D
MOUNT KISCO NY
10549-3028
US

IV. Provider business mailing address

344 E MAIN ST STE 206
MOUNT KISCO NY
10549-3036
US

V. Phone/Fax

Practice location:
  • Phone: 914-666-7367
  • Fax: 914-666-7416
Mailing address:
  • Phone: 914-666-7367
  • Fax: 914-666-7416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN005062-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License NumberN005062-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberN005062-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN005062-1
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN005062-1
License Number StateNY
# 6
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberN005062-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: