MEDICARE: ALFRED BERKOVITS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	30087	NY

General Provider Information

NPI Number	:	1184948465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALFRED BERKOVITS

Provider Business Mailing Address
First Line	:	5504-13 AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4515
Country	:	US
Telephone Number	:	718-436-6088
Fax Number	:	718-436-3649

Provider Business Practice Location Address
First Line	:	5504-13 AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4515
Country	:	US
Telephone Number	:	718-436-6088
Fax Number	:	718-436-3649

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2010
Last Update Date	:	03/16/2010

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