Provider Demographics
NPI:1508066226
Name:BERKOWITZ, ELAINE HARRIET (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:HARRIET
Last Name:BERKOWITZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ELAINE
Other - Middle Name:HARRIET
Other - Last Name:BERKOWITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:607 MAPLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-3331
Mailing Address - Country:US
Mailing Address - Phone:412-487-7580
Mailing Address - Fax:
Practice Address - Street 1:607 MAPLEWOOD CT
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-3331
Practice Address - Country:US
Practice Address - Phone:412-487-7580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025285L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice