Provider Demographics
NPI:1568575371
Name:BERKOWITZ, JESSICA P (RN BSN)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:P
Last Name:BERKOWITZ
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 RUSSET ROAD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601
Mailing Address - Country:US
Mailing Address - Phone:845-471-8589
Mailing Address - Fax:
Practice Address - Street 1:88 FOX HOLLOW ROAD
Practice Address - Street 2:DAYTOP VILLAGE
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572
Practice Address - Country:US
Practice Address - Phone:845-876-6823
Practice Address - Fax:845-876-3276
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4375961163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse