MEDICARE: DR. ALAN MEYERBERG

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	332BC3200X	Customized Equipment (DME)	25MD00213900	NJ
2	332BC3200X	Customized Equipment (DME)	N003271	NY

General Provider Information

NPI Number	:	1538326723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. ALAN MEYERBERG

Provider Business Mailing 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

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	:	OWNER
Name	:	DR. ALAN MEYERBERG
Credential	:	DPM
Telephone Number	:	718-948-3788

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	05/30/2008

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