Organization
IRA C. BERKOWITZ,MD PC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRA CHARLES BERKOWITZ M.D. (PHYSICIAN/PRESIDENT)
(505) 820-0446
Entity
Organization
Contact information
Practice address
2019 GALISTEO ST, SANTA FE, NM 87505-2143
(505) 820-0446
Mailing address
2019 GALISTEO ST, SUITE J-1, SANTA FE, NM 87505-2143
(505) 820-0446
(505) 820-6142
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
82-167
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18689
—
NM
Enumeration date
10/16/2006
Last updated
03/21/2008
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