Provider Demographics
NPI:1346221546
Name:WEBER, HARVEY (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:
Last Name:WEBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 HICKSVILLE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3471
Mailing Address - Country:US
Mailing Address - Phone:516-576-5832
Mailing Address - Fax:516-576-5801
Practice Address - Street 1:530 HICKSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-3415
Practice Address - Country:US
Practice Address - Phone:516-937-5000
Practice Address - Fax:516-931-2535
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY141832207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA60643Medicare UPIN
NY13D911Medicare ID - Type Unspecified