Provider Demographics
NPI:1871601153
Name:BERKOWER, ALAN STEWART (MD PHD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:STEWART
Last Name:BERKOWER
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3250 WESTCHESTER AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-4500
Mailing Address - Country:US
Mailing Address - Phone:718-518-9304
Mailing Address - Fax:718-518-9401
Practice Address - Street 1:3250 WESTCHESTER AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4500
Practice Address - Country:US
Practice Address - Phone:718-518-9304
Practice Address - Fax:718-518-9401
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY166774207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01130345Medicaid
NY17F131Medicare PIN
NYD92020Medicare UPIN