Doctor Name: | MR. GILBERT BEROOKHIM |
NPI Number: | 1932182375 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DDS |
License Number: | 043616 |
Business Practice Address: | 5611 Catalpa Ave Ridgewood, NY - 113854841 |
Business Phone Number: | 7184170117 |
Business Fax Number: | 7183815450 |
Mailing Address: | 5611 Catalpa Ave, RIDGEWOOD |
State: | NY |
Postal Code: | 113854841 |
Phone Number: | 7184170117 |
Fax Number: | 7183815450 |
NPI Enumeration Date: | 11/21/2005 |
NPI Last Update Date: | 04/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 043616 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |