Individual provider · NPI-1
Dr. Roy Berenholtz, MD
Anesthesiology, Pediatric Anesthesiology · Fresh Meadows, NY
NPI number1215194261
StatusActive
Last updated in NPPESFeb 25, 2021
Details
- NPI
- 1215194261
- Entity type
- Individual (NPI-1)
- Name
- Dr. Roy Berenholtz
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 19, 2008
- Certification date
- Feb 25, 2021
- Last updated
- Feb 25, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207LP3000X | Anesthesiology, Pediatric Anesthesiology | MT191459 | PA | Yes |
| 207R00000X | Internal Medicine | 240666 | NY | |
| 207L00000X | Anesthesiology | 240666 | NY |
Other names
- Roy Berenholtz (Professional Name)
Practice location
17918 69th AveFresh Meadows, NY 11365-3520
Phone 718-838-0777
Mailing address
17918 69th AveFresh Meadows, NY 11365-3520
Phone 718-838-0777
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.