Individual
DR. BETSY BERKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
7B JOHNSON RD, LATHAM, NY 12110-3003
(518) 782-7733
Mailing address
7B JOHNSON RD, LATHAM, NY 12110-3003
(518) 782-7733
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
275895
NY
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
275895
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03932881
—
NY
01
—
456ZM1
EMPIRE BLUECROOS BLUESHIELD
NY
05
—
485103
—
AZ
01
—
8HBU69
MEDICARE PART B - PARKER
AZ
01
—
9783416
AETNA
NY
Enumeration date
10/02/2006
Last updated
03/18/2015
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