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General NPI Number Information
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NPI Number | 1386649515
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Entity Type | Individual
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Provider Name | ALAN M MEYERBERG D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 4277 RICHMOND AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-6241
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Country | US
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Telephone | 718-948-3788
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Fax | 718-948-1394
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Provider Business Mailing Address
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Address Line | 29 DUNCAN DR
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1605
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Country | US
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Telephone | 732-322-9887
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | N003271
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 25MD00213900
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License Number State | NJ
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