Healthcare Provider Details

I. General information

NPI: 1811929482
Provider Name (Legal Business Name): DAVID NEUBERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 05/31/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 1ST ST
MINEOLA NY
11501-3957
US

IV. Provider business mailing address

PO BOX 194
POINT LOOKOUT NY
11569-0194
US

V. Phone/Fax

Practice location:
  • Phone: 516-663-2727
  • Fax: 516-663-8549
Mailing address:
  • Phone: 610-551-2400
  • Fax: 888-873-8357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD428742
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number235651
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number235651
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: