Healthcare Provider Details

I. General information

NPI: 1558384867
Provider Name (Legal Business Name): ERIC LEWIN ALTSCHULER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 1ST AVE DEPT PM&R
NEW YORK NY
10029-7404
US

IV. Provider business mailing address

157 EAST 81ST STREET 4A
NEW YORK NY
10028
US

V. Phone/Fax

Practice location:
  • Phone: 212-423-6448
  • Fax: 212-423-6326
Mailing address:
  • Phone: 646-784-3543
  • Fax: 212-423-6326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD451984
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number25MA07902500
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number227788
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: