MEDICARE: MICHAEL RICHARD BARTELS RPH

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	042672	NY

General Provider Information

NPI Number	:	1487976627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL RICHARD BARTELS RPH

Provider Business Mailing Address
First Line	:	1229 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-5105
Country	:	US
Telephone Number	:	212-249-1050
Fax Number	:	212-794-1174

Provider Business Practice Location Address
First Line	:	1229 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-5105
Country	:	US
Telephone Number	:	212-249-1050
Fax Number	:	212-794-1174

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2010
Last Update Date	:	02/15/2010

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