Provider Demographics
NPI:1821299587
Name:WABREK, ALAN J (MD, DRPH)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:J
Last Name:WABREK
Suffix:
Gender:M
Credentials:MD, DRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-2424
Mailing Address - Country:US
Mailing Address - Phone:607-778-3917
Mailing Address - Fax:607-778-2838
Practice Address - Street 1:225 FRONT ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-2424
Practice Address - Country:US
Practice Address - Phone:607-778-2802
Practice Address - Fax:607-778-2838
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111966-12083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE47036Medicare UPIN