Provider Demographics
NPI:1679586846
Name:BRUMBERG, ANDREW JAY (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JAY
Last Name:BRUMBERG
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 1:8503 PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-6442
Mailing Address - Country:US
Mailing Address - Phone:804-740-3400
Mailing Address - Fax:804-741-9420
Practice Address - Street 1:8503 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-6442
Practice Address - Country:US
Practice Address - Phone:804-740-3400
Practice Address - Fax:804-741-9420
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000349111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor