Basic Information
| Provider Information | |||||||||
| NPI: | 1578295762 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERKOWITZ | ||||||||
| FirstName: | ZISI | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6 LOWELL AVE | ||||||||
| Address2: | |||||||||
| City: | NEW HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110402810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163264160 | ||||||||
| FaxNumber: | 5163543916 | ||||||||
| Practice Location | |||||||||
| Address1: | ADVANCED DERMATOLOGY, PC | ||||||||
| Address2: | 100 SOUTH HIGHLAND AVE | ||||||||
| City: | OSSINING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149415770 | ||||||||
| FaxNumber: | 5163543916 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2022 | ||||||||
| LastUpdateDate: | 11/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.