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General NPI Number Information
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NPI Number | 1356795066
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Entity Type | Individual
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Provider Name | RACAHEL BERKOWITZ
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Gender | Female
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Dates
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Enumeration Date | 04/19/2016
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Last Update Date | 04/19/2016
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Provider Practice Location Address
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Address Line | 23 EDNA DR
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City | SYOSSET
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State | NY
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Zip | 11791-3717
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Country | US
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Telephone | 516-584-6179
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Fax |
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Provider Business Mailing Address
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Address Line | 23 EDNA DR
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City | SYOSSET
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State | NY
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Zip | 11791-3717
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Country | US
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Telephone | 516-584-6179
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 840465
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 000287-1
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License Number State | NY
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