Provider Demographics
NPI:1306023585
Name:PRAMBERGER, PETER ANTON (DC)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:ANTON
Last Name:PRAMBERGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 JEROME ST
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-5403
Mailing Address - Country:US
Mailing Address - Phone:516-857-4956
Mailing Address - Fax:
Practice Address - Street 1:205 JEROME ST
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-5403
Practice Address - Country:US
Practice Address - Phone:516-857-4956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002996111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor