MEDICARE: DR. ALAN M MEYERBERG D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	N003271	NY
2	213ES0103X	Foot & Ankle Surgery Podiatrist	25MD00213900	NJ

General Provider Information

NPI Number	:	1386649515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN M MEYERBERG D.P.M.

Provider Business Mailing Address
First Line	:	29 DUNCAN DR
Second Line	:
City	:	MORGANVILLE
State	:	NJ
Zip	:	07751-1605
Country	:	US
Telephone Number	:	732-322-9887
Fax Number	:

Provider Business Practice Location Address
First Line	:	4277 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-6241
Country	:	US
Telephone Number	:	718-948-3788
Fax Number	:	718-948-1394

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	05/30/2008

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