| NPI | 1104992593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOV JAY BERKOWITZ Owner 718-575-5454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 1523851) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: NY 1523851) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: NY 1523851) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |