Provider Demographics
NPI:1679982144
Name:BERKOWITZ, ALISON (COTA)
Entity type:Individual
Prefix:MS
First Name:ALISON
Middle Name:
Last Name:BERKOWITZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5828 47TH AVE
Mailing Address - Street 2:2
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377
Mailing Address - Country:US
Mailing Address - Phone:917-859-7105
Mailing Address - Fax:
Practice Address - Street 1:5828 47TH AVE
Practice Address - Street 2:2
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-5530
Practice Address - Country:US
Practice Address - Phone:917-859-7105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008483-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant