Provider Demographics
NPI:1528365244
Name:BERKOVITCH, ALAN (DPT)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:BERKOVITCH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:794 ARBUCKLE AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2706
Mailing Address - Country:US
Mailing Address - Phone:718-249-6048
Mailing Address - Fax:718-228-2644
Practice Address - Street 1:1272 51ST ST LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3663
Practice Address - Country:US
Practice Address - Phone:718-249-6048
Practice Address - Fax:718-228-2644
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033457225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist