Provider Demographics
NPI:1649416215
Name:BERKOWITZ, KAREN ETHEL (OTR)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ETHEL
Last Name:BERKOWITZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 E 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-3601
Mailing Address - Country:US
Mailing Address - Phone:718-377-0399
Mailing Address - Fax:
Practice Address - Street 1:941 E 13TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-3601
Practice Address - Country:US
Practice Address - Phone:718-377-0399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-01
Last Update Date:2009-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005256-1171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor