# IRA C. BERKOWITZ,MD PC, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538249362
- **Authorized official:** IRA CHARLES BERKOWITZ M.D. (PHYSICIAN/PRESIDENT)
- **Authorized official phone:** (505) 820-0446

## Contact information

- **Practice address:** 2019 GALISTEO ST, SANTA FE, NM 87505-2143
- **Practice address phone:** (505) 820-0446
- **Mailing address:** 2019 GALISTEO ST, SUITE J-1, SANTA FE, NM 87505-2143
- **Mailing address phone:** (505) 820-0446
- **Mailing address fax:** (505) 820-6142

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 82-167 | NM | Yes |

## Other

- **Enumeration date:** 10/16/2006
- **Last updated:** 03/21/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 18689 | — | NM |