Individual
SAMUEL BERKOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
99 ASH ST, EAST HARTFORD, CT 06108-3226
(860) 679-6600
(860) 679-6604
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P00295
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407851165
—
CT
Enumeration date
06/17/2005
Last updated
04/16/2013
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