MEDICARE: DOCTORS MEDICAL OFFICE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	261QR0200X	Radiology Clinic/Center
3	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1164848818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTORS MEDICAL OFFICE PLLC

Provider Business Mailing Address
First Line	:	1825 MERRICK RD
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-4559
Country	:	US
Telephone Number	:	516-867-5132
Fax Number	:	516-867-5519

Provider Business Practice Location Address
First Line	:	1825 MERRICK RD
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-4559
Country	:	US
Telephone Number	:	516-867-5132
Fax Number	:	516-867-5519

Authorized Official
Title or Position	:	MANAGER/MEMBER
Name	:	DR. MARK HALTRECHT
Credential	:	DO
Telephone Number	:	516-867-5132

Provider Enumeration Date	:	03/05/2014
Last Update Date	:	01/07/2026

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