Provider Demographics
NPI:1952857492
Name:BERANBAUM, KHILNANI, NEISTADT, JACOBS, HERTZ AND SHERMAN, M.D., P.C.
Entity Type:Organization
Organization Name:BERANBAUM, KHILNANI, NEISTADT, JACOBS, HERTZ AND SHERMAN, M.D., P.C.
Other - Org Name:BREASTLINK OF NEW YORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-445-2800
Mailing Address - Street 1:5 COLUMBUS CIR
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1412
Mailing Address - Country:US
Mailing Address - Phone:212-664-9323
Mailing Address - Fax:212-664-9341
Practice Address - Street 1:5 COLUMBUS CIR
Practice Address - Street 2:8TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1412
Practice Address - Country:US
Practice Address - Phone:212-664-9323
Practice Address - Fax:212-664-9341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-25
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty