Active NPI
Sam J Bercovich
- Specialist
- Dobbs Ferry, NY
National Provider Identifier
1396101044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 1329084
- Practice address
- 110 Draper LN
Apt 1GS
Dobbs Ferry, NY 10522-1011 - Phone
- (718) 344-8092
- NPI assigned
- Jan 11, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 1329084 | NY | Primary |
Addresses
Primary practice location
110 Draper LN
Apt 1GS
Dobbs Ferry, NY 10522-1011
Mailing address
110 Draper LN
Apt 1GS
Dobbs Ferry, NY 10522-1011
Phone (718) 344-8092
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1329084 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452470400000",
"number": "1396101044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 DRAPER LN",
"address_2": "APT 1GS",
"city": "DOBBS FERRY",
"state": "NY",
"postal_code": "105221011",
"telephone_number": "718-344-8092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 DRAPER LN",
"address_2": "APT 1GS",
"city": "DOBBS FERRY",
"state": "NY",
"postal_code": "105221011",
"telephone_number": "718-344-8092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERCOVICH",
"first_name": "SAM",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-01-11",
"last_updated": "2016-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "1329084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dobbs Ferry, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.