Provider Demographics
NPI:1821189317
Name:BERKOWITZ, JOAN GOLDIN (L)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:GOLDIN
Last Name:BERKOWITZ
Suffix:
Gender:F
Credentials:L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HAMILTON LN
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2005
Mailing Address - Country:US
Mailing Address - Phone:973-994-0714
Mailing Address - Fax:973-994-0714
Practice Address - Street 1:215 RIDGEDALE AVE
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1355
Practice Address - Country:US
Practice Address - Phone:973-994-0714
Practice Address - Fax:973-994-0714
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051842001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ149756Medicare PIN