# BARRY M ALTENBERG MD SC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ALTENBERG CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669565347
- **Authorized official:** DR. BARRY M ALTENBERG MD (OWNER/PRESIDENT)
- **Authorized official phone:** (262) 898-7100

## Contact information

- **Practice address:** 5802 WASHINGTON AVE, RACINE, WI 53406
- **Practice address phone:** (262) 886-5700
- **Practice address fax:** (262) 886-4747
- **Mailing address:** 1055 PRAIRIE DR, SUITE D, RACINE, WI 53406
- **Mailing address phone:** (262) 898-7100
- **Mailing address fax:** (262) 898-7171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | WI15872 | WI | Yes |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 06/25/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 31175300 | — | WI |
| 05 | — | 32891300 | — | WI |