Provider Demographics
NPI:1811275514
Name:BERLACH, DAVID (MD CM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:BERLACH
Suffix:
Gender:M
Credentials:MD CM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 8TH AVE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4718
Mailing Address - Country:US
Mailing Address - Phone:718-765-2700
Mailing Address - Fax:718-765-2661
Practice Address - Street 1:6300 8TH AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4718
Practice Address - Country:US
Practice Address - Phone:718-765-2700
Practice Address - Fax:718-765-2661
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-28
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2660092085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology