Provider Demographics
NPI:1467552422
Name:DEBRA L BIRNBAUM D C P A
Entity Type:Organization
Organization Name:DEBRA L BIRNBAUM D C P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BIRNBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-731-0041
Mailing Address - Street 1:112 S FEDERAL HWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-4939
Mailing Address - Country:US
Mailing Address - Phone:561-731-0041
Mailing Address - Fax:561-737-7088
Practice Address - Street 1:112 S FEDERAL HWY
Practice Address - Street 2:SUITE 2
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-4939
Practice Address - Country:US
Practice Address - Phone:561-731-0041
Practice Address - Fax:561-737-7088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAG385Medicare PIN