Provider Demographics
NPI:1518085687
Name:BERKOWITZ, ROBERT G (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:BERKOWITZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 WOODBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-3234
Mailing Address - Country:US
Mailing Address - Phone:732-572-7070
Mailing Address - Fax:732-572-7572
Practice Address - Street 1:34 WOODBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-3234
Practice Address - Country:US
Practice Address - Phone:732-572-7070
Practice Address - Fax:732-572-7572
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC O2128111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor