Provider Demographics
NPI:1962598078
Name:HALBREICH, URIEL MORAV (MD)
Entity type:Individual
Prefix:PROF
First Name:URIEL
Middle Name:MORAV
Last Name:HALBREICH
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3435 MAIN ST BLDG 5
Mailing Address - Street 2:BIOBEHAVIOR PROGRAM,SUNY-AB,HAYES C,STE 1
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-3016
Mailing Address - Country:US
Mailing Address - Phone:716-929-3808
Mailing Address - Fax:716-829-3812
Practice Address - Street 1:3435 MAIN ST BLDG 5
Practice Address - Street 2:BIOBEHAVIOR PROGRAM,SUNY-AB,HAYES C,STE 1
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-3016
Practice Address - Country:US
Practice Address - Phone:716-929-3808
Practice Address - Fax:716-829-3812
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY153 4082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA96123Medicare UPIN