Provider Demographics
NPI:1093960841
Name:BERKOWITZ, DOVID (PSY D)
Entity Type:Individual
Prefix:
First Name:DOVID
Middle Name:
Last Name:BERKOWITZ
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 ROUTE 45 STE 216
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3530
Mailing Address - Country:US
Mailing Address - Phone:845-354-1547
Mailing Address - Fax:
Practice Address - Street 1:971 ROUTE 45 STE 216
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3530
Practice Address - Country:US
Practice Address - Phone:845-354-1547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016949103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist