Provider Demographics
NPI:1639120512
Name:NEIBART, ERIC P (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:P
Last Name:NEIBART
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 1:1100 PARK AVE
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1202
Mailing Address - Country:US
Mailing Address - Phone:212-427-9550
Mailing Address - Fax:
Practice Address - Street 1:1100 PARK AVE
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1202
Practice Address - Country:US
Practice Address - Phone:212-427-9550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY147878-1207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN74672OtherHEALTHNET PROVIDER NUMBER
NY00785093Medicaid
NY9632550OtherGHI PROVIDER NUMBER
NYNS533OtherOXFORD PROVIDER NUMBER
NY415469OtherUHC PROVIDER NUMBER
NY133411983OtherTAX IDENTIFICATION NUMBER
NYB79962Medicare UPIN
NYNS533OtherOXFORD PROVIDER NUMBER