Basic Information
| Provider Information | |||||||||
| NPI: | 1497849913 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERKOWITZ | ||||||||
| FirstName: | ALLEN | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 ASYLUM AVE | ||||||||
| Address2: | SUITE 2126 | ||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061051770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8607286740 | ||||||||
| FaxNumber: | 8605471554 | ||||||||
| Practice Location | |||||||||
| Address1: | 299 CAREW ST STE 409 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011042361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137887321 | ||||||||
| FaxNumber: | 4137336369 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 09/13/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 56087 | CT | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 273339 | MA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 2086S0105X | 56087 | CT | N | Allopathic & Osteopathic Physicians | Surgery | Surgery of the Hand | 2086S0105X | 273339 | MA | Y | Allopathic & Osteopathic Physicians | Surgery | Surgery of the Hand |
ID Information
| ID | Type | State | Issuer | Description | 2K3426 | 01 | NJ | HEALTHNET | OTHER | 0500852 | 01 | NJ | GHI | OTHER | 1243632 | 01 | NJ | UNITED HEALTHCARE | OTHER | 157010 | 01 | NJ | GREAT WEST | OTHER | 6568F02204 | 01 | NJ | 1ST OPTION | OTHER | 3733523B | 01 | NJ | CIGNA | OTHER | 4221720 | 01 | NJ | AETNA | OTHER | 0196709000 | 01 | NJ | AMERIHEALTH | OTHER | 0196709000 | 01 | NJ | KEYSTONE | OTHER | BNS011 | 01 | NJ | OXFORD | OTHER |