Provider Demographics
NPI:1356372544
Name:WEBER, ANDREW SETH (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:SETH
Last Name:WEBER
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 1:2 PHYLLIS DR
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-6015
Mailing Address - Country:US
Mailing Address - Phone:516-579-3032
Mailing Address - Fax:516-579-0160
Practice Address - Street 1:2 PHYLLIS DR
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-6015
Practice Address - Country:US
Practice Address - Phone:516-579-3032
Practice Address - Fax:516-579-0160
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY150534207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY19E951Medicare ID - Type Unspecified
NYA61132Medicare UPIN