Healthcare Provider Details

I. General information

NPI: 1891633939
Provider Name (Legal Business Name): MR. MICHAEL JOSEPH BARTELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5945 161ST ST
FRESH MEADOWS NY
11365-1414
US

IV. Provider business mailing address

4110 BOWNE ST APT 7X
FLUSHING NY
11355-5605
US

V. Phone/Fax

Practice location:
  • Phone: 718-395-4522
  • Fax:
Mailing address:
  • Phone: 714-931-6293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: