Debra J. Wattenberg, M.D.,P.C

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

178869 Issued in NY

Legal business name

DEBRA J. WATTENBERG, M.D.,P.C

Practice address

875 5TH Ave
69TH St, 2B
New York, NY 10065-4952

Phone

(212) 288-3200

Fax

(212) 288-3226

NPI assigned

Apr 30, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Debra Joy Wattenberg, M.D.NPI 1437191236

Title

Owner

Phone

(212) 288-3200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jamie Rosen Manning

  • Dermatology Physician
  • New York, NY
  • NPI 1578919858
  Medicare reassignment Care Compare group NPD
• Ilyse Simone Lefkowicz, M.D.

  • Dermatology Physician
  • Englewood, NJ
  • NPI 1164432043

  NY

  Medicare reassignment Care Compare group NPD
• Debra Joy Wattenberg, M.D.

  • Procedural Dermatology Physician
  • New York, NY
  • NPI 1437191236
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1740455765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 5TH AVE",
            "address_2": "69TH ST, 2B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654952",
            "telephone_number": "212-288-3200",
            "fax_number": "212-288-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 5TH AVE",
            "address_2": "69TH ST, 2B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654952",
            "telephone_number": "212-288-3200",
            "fax_number": "212-288-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBRA J. WATTENBERG, M.D.,P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "WATTENBERG",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-288-3200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "178869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Gahr MD PLLC
• Deborah Missud Mental Health Counseling PLLC
• Deborah Stotzky Acupuncture LLC
• Debra Abramson
• Debra Green, MD PLLC
• Debra M Kroll MD LLC
• Debra M. Kroll, MD, LLC
• Debra Posner, LCSW, P.C.
• Charles H Debrovner, MD
• Barbara Ann Debuono, MD, MPH

• Legal Medicine in New York, NY
• Providers in New York, NY by specialty
• Legal Medicine in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.