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NPI Code Detail

MEDICARE: ALLISON J BEITLER MD

MEDICARE: ALLISON J BEITLER MD
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
1207R00000XInternal Medicine Physician194665NY
2207RR0500XRheumatology Physician194665NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902893936
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON J BEITLER MD
Provider Business Mailing Address
First Line : 630 W 168TH ST # 4
Second Line :
City : NEW YORK
State : NY
Zip : 10032-3725
Country : US
Telephone Number : 212-305-4308
Fax Number : 212-304-6610
Provider Business Practice Location Address
First Line : 685 WHITE PLAINS RD
Second Line :
City : EASTCHESTER
State : NY
Zip : 10709-5545
Country : US
Telephone Number : 914-787-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2005
Last Update Date : 12/12/2022

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