Healthcare Provider Details

I. General information

NPI: 1609059849
Provider Name (Legal Business Name): ARNOLD S BREITBART MD FACS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 04/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 NORTHERN BLVD SUITE 110
MANHASSET NY
11030-3040
US

IV. Provider business mailing address

1155 NORTHERN BLVD SUITE 110
MANHASSET NY
11030-3040
US

V. Phone/Fax

Practice location:
  • Phone: 516-365-3511
  • Fax: 516-365-3611
Mailing address:
  • Phone: 516-365-3511
  • Fax: 516-365-3611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ARNOLD S BREITBART
Title or Position: OWNER
Credential: M.D.
Phone: 516-365-3511