Provider Demographics
NPI:1942398516
Name:WEISBERG, ALLAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:
Last Name:WEISBERG
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 1:235 E49 ST
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017
Mailing Address - Country:US
Mailing Address - Phone:212-688-2900
Mailing Address - Fax:212-759-8046
Practice Address - Street 1:235 E 49TH ST
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1537
Practice Address - Country:US
Practice Address - Phone:212-688-2900
Practice Address - Fax:212-759-8046
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX16511111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX16511Medicare PIN