Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | P93183 | NY |
NPI | 1083023154 |
---|---|
Provider Name | Joseph Berkovic |
First Address | Bronx, NY 10457-2545 |
Second Address | Bronx, NY 10457-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2014 |
Last Update Date | 08/07/2016 |