Provider Demographics
NPI:1952351439
Name:BERLIN, SCOTT F (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:F
Last Name:BERLIN
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 1:2330 UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-3103
Mailing Address - Country:US
Mailing Address - Phone:631-224-4200
Mailing Address - Fax:631-224-1798
Practice Address - Street 1:2330 UNION BLVD
Practice Address - Street 2:
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-3103
Practice Address - Country:US
Practice Address - Phone:631-224-4200
Practice Address - Fax:631-224-1798
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193341207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01849669Medicaid
NYF95656Medicare UPIN
NY52J271Medicare ID - Type Unspecified