Provider Demographics
NPI:1851588842
Name:WEINBERGER& GAGLIOTI OD PC
Entity Type:Organization
Organization Name:WEINBERGER& GAGLIOTI OD PC
Other - Org Name:CROTON VISION CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEINBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:914-271-9411
Mailing Address - Street 1:179 S RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-2605
Mailing Address - Country:US
Mailing Address - Phone:914-271-9411
Mailing Address - Fax:914-271-6460
Practice Address - Street 1:179 S RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-2605
Practice Address - Country:US
Practice Address - Phone:914-271-9411
Practice Address - Fax:914-271-6460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0046100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW23261Medicare PIN
NYCM2951Medicare PIN
NY0649790001Medicare NSC