Provider Demographics
NPI:1609934587
Name:NEUBURGER, NAFTOLI (MD)
Entity Type:Individual
Prefix:DR
First Name:NAFTOLI
Middle Name:
Last Name:NEUBURGER
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 1:1332 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-5113
Mailing Address - Country:US
Mailing Address - Phone:718-438-9333
Mailing Address - Fax:
Practice Address - Street 1:1469 48TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3244
Practice Address - Country:US
Practice Address - Phone:718-438-9333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY132072174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00577308Medicaid
NY00577308Medicaid
NYB14916Medicare UPIN