Provider Demographics
NPI:1265534564
Name:BERKOWITZ, LEONARD BRUCE (MD)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:BRUCE
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 1:240 WILLOUGHBY ST
Mailing Address - Street 2:SUITE 5H THE BROOKLYN HOSPITAL CENTER
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201
Mailing Address - Country:US
Mailing Address - Phone:718-250-6922
Mailing Address - Fax:718-250-6471
Practice Address - Street 1:240 WILLOUGHBY ST
Practice Address - Street 2:SUITE 5H
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:718-250-6922
Practice Address - Fax:718-250-6471
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY145179207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00787788Medicaid
B20448Medicare UPIN
NY00787788Medicaid