MEDICARE: DR. ERIC J OBERMAN D.O.

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	208000000X	Pediatrics Physician	216899	NY

General Provider Information

NPI Number	:	1932140035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC J OBERMAN D.O.

Provider Business Mailing Address
First Line	:	422 WESTERN HWY
Second Line	:
City	:	TAPPAN
State	:	NY
Zip	:	10983-1311
Country	:	US
Telephone Number	:	845-359-0010
Fax Number	:	845-359-3414

Provider Business Practice Location Address
First Line	:	422 WESTERN HWY
Second Line	:
City	:	TAPPAN
State	:	NY
Zip	:	10983-1311
Country	:	US
Telephone Number	:	845-359-0010
Fax Number	:	845-359-3414

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	04/05/2012

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