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:
Health care specialties
| Specialty | Code | License # | 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 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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