Provider Demographics
NPI:1144236332
Name:EBLING, DAVID W (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:EBLING
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 95000-5560
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-5560
Mailing Address - Country:US
Mailing Address - Phone:888-220-1235
Mailing Address - Fax:865-450-9374
Practice Address - Street 1:259 1ST ST
Practice Address - Street 2:RADIATION ONCOLOGY
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3957
Practice Address - Country:US
Practice Address - Phone:516-663-2501
Practice Address - Fax:516-663-8558
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2015-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2267582085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG55530Medicare UPIN
NY2212E1Medicare ID - Type Unspecified