Provider Demographics
NPI:1538106158
Name:BERKOWITZ, IRWIN HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:IRWIN
Middle Name:HOWARD
Last Name:BERKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 CHESTNUT RIDGE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WOODCLIFF LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07677-7663
Mailing Address - Country:US
Mailing Address - Phone:201-391-2020
Mailing Address - Fax:201-391-0265
Practice Address - Street 1:595 CHESTNUT RIDGE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:WOODCLIFF LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07677-7663
Practice Address - Country:US
Practice Address - Phone:201-391-2020
Practice Address - Fax:201-391-0265
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03143400208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics