Provider Demographics
NPI:1558413500
Name:ABERGER, BRIAN A (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:A
Last Name:ABERGER
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 1:16401 JEWEL AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11365-4227
Mailing Address - Country:US
Mailing Address - Phone:718-380-7738
Mailing Address - Fax:718-969-6650
Practice Address - Street 1:16401 JEWEL AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11365-4227
Practice Address - Country:US
Practice Address - Phone:718-380-7738
Practice Address - Fax:718-969-6650
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004263-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT31733Medicare UPIN
NY06784Medicare ID - Type Unspecified