Provider Demographics
NPI:1275634990
Name:NEW YORK GYNECOLOGICAL &OBSTETRICAL ASSOCIATES
Entity Type:Organization
Organization Name:NEW YORK GYNECOLOGICAL &OBSTETRICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BERK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-684-5522
Mailing Address - Street 1:145 E 32ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6055
Mailing Address - Country:US
Mailing Address - Phone:212-684-5522
Mailing Address - Fax:212-576-1051
Practice Address - Street 1:145 E 32ND ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6055
Practice Address - Country:US
Practice Address - Phone:212-684-5522
Practice Address - Fax:212-576-1051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY100782150 08Medicaid
NYB07030Medicare UPIN
NY100782150 08Medicaid