Healthcare Provider Details
I. General information
NPI: 1215175435
Provider Name (Legal Business Name): ANA BERLIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/26/2009
Last Update Date: 11/13/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
177 FORT WASHINGTON AVENUE MILSTEIN HOSPITAL BUILDING 7 SOUTH KNUCKLE 014
NEW YORK NY
10032
US
IV. Provider business mailing address
177 FORT WASHINGTON AVENUE MILSTEIN HOSPITAL BUILDING 7 SOUTH KNUCKLE 014
NEW YORK NY
10032
US
V. Phone/Fax
- Phone: 212-342-1734
- Fax:
- Phone: 212-342-1734
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 25MA09523400 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086H0002X |
| Taxonomy | Hospice and Palliative Medicine (Surgery) Physician |
| License Number | 254287 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 254287 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: