Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 164495 | NY |
NPI | 1023035789 |
---|---|
Provider Name | Deborah Weichenberg |
First Address | New York, NY 10024 |
Second Address | New York, NY 10023-1786 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 25/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01601165 | (05) | NY |
E53224 | (02) |