Berk, Otto Michael

Berk, Otto Michael is an sole proprietor health care provider with primary practice located at 6762 Burns St , Forest Hills NY 11375-3537. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Berk, Otto Michael can be contacted via phone (718) 544-5522.

Contact Information

Primary practice address
6762 Burns St Forest Hills NY 11375-3537
Phone: (718) 544-5522
Fax: (718) 544-2345
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X R-042031 New York

Profile Details

NPI number 1225033525
LBN Legal business name Berk, Otto Michael
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 15th, 2005
Last updated Feb 15th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225033525 NPPES
New York Other 182780P HIP NY STATE
New York Other 2445244 HIP NY STATE
New York MEDICAID 02480211 HIP NY STATE
New York Other 2826599000 HIP NY STATE
New York Other 558471000 HIP NY STATE
New York Other 1050730 HIP NY STATE
New York Other 518370 HIP NY STATE
New York Other N797C1 HIP NY STATE
New York Other 10208395 HIP NY STATE
New York Other 518370 HIP NY STATE
New York Other 7527622 HIP NY STATE
New York Other 248062964 HIP NY STATE
New York Other 307450 HIP NY STATE
New York Other P3462946 HIP NY STATE

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