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General NPI Number Information
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NPI Number | 1568482685
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Entity Type | Individual
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Provider Name | IRA K BERLINER M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 560 NORTHERN BLVD SUITE 103
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City | GREAT NECK
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State | NY
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Zip | 11021-5100
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Country | US
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Telephone | 516-482-8741
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Fax |
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Provider Business Mailing Address
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Address Line | 22 WATERVILLE RD WHNY MANAGED CARE
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City | AVON
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State | CT
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Zip | 06001-2066
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Country | US
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Telephone | 860-676-7421
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 143790
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 143790
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 143790
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License Number State | NY
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