Provider Demographics
NPI:1467911164
Name:BERKOVITS, AVIVA LAYA
Entity Type:Individual
Prefix:MRS
First Name:AVIVA
Middle Name:LAYA
Last Name:BERKOVITS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 E 28TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-5311
Mailing Address - Country:US
Mailing Address - Phone:917-865-1941
Mailing Address - Fax:
Practice Address - Street 1:1324 E 28TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-5311
Practice Address - Country:US
Practice Address - Phone:917-865-1941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst