Provider Demographics
NPI:1336309541
Name:ALEXANDER BERENBLIT, M.D.
Entity Type:Organization
Organization Name:ALEXANDER BERENBLIT, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BERENBLIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-437-6500
Mailing Address - Street 1:581 OCEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-5913
Mailing Address - Country:US
Mailing Address - Phone:718-437-6500
Mailing Address - Fax:718-437-2711
Practice Address - Street 1:581 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5913
Practice Address - Country:US
Practice Address - Phone:718-437-6500
Practice Address - Fax:718-437-2711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1571332084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00850000Medicaid
NYA61805Medicare UPIN
NY28D181Medicare PIN