Healthcare Provider Details

I. General information

NPI: 1134142714
Provider Name (Legal Business Name): JOEL S BUCHALTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

664 STONELEIGH AVE STE 300 SOMERS ORTHOPAEDIC SURGERY AND SPORTS MED GR PL
CARMEL NY
10512-3940
US

IV. Provider business mailing address

40 OLD RIDGEBURY RD STE 101
DANBURY CT
06810-5123
US

V. Phone/Fax

Practice location:
  • Phone: 845-278-8400
  • Fax: 845-278-4326
Mailing address:
  • Phone: 203-397-6872
  • Fax: 203-207-0304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number29668
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number158554
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number158554
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number29668
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: