Healthcare Provider Details

I. General information

NPI: 1265439129
Provider Name (Legal Business Name): DAVID ERIC BIRO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/06/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9921 4TH AVE
BROOKLYN NY
11209-8347
US

IV. Provider business mailing address

9921 4TH AVE
BROOKLYN NY
11209-8347
US

V. Phone/Fax

Practice location:
  • Phone: 718-833-7616
  • Fax: 718-680-4297
Mailing address:
  • Phone: 718-833-7616
  • Fax: 718-680-4297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number194876
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: