Basic Information
| Provider Information | |||||||||
| NPI: | 1821299587 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WABREK | ||||||||
| FirstName: | ALAN | ||||||||
| MiddleName: | J. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D., DR.PH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 225 FRONT ST | ||||||||
| Address2: | |||||||||
| City: | BINGHAMTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 139052424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077783917 | ||||||||
| FaxNumber: | 6077782838 | ||||||||
| Practice Location | |||||||||
| Address1: | 225 FRONT ST | ||||||||
| Address2: | |||||||||
| City: | BINGHAMTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 139052424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077782802 | ||||||||
| FaxNumber: | 6077782838 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083P0901X | 111966-1 | NY | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Public Health & General Preventive Medicine |
No ID Information.