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General NPI Number Information
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NPI Number | 1013175165
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Entity Type | Organization
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Legal Business Name | MICHAEL PALTIEL MD PC
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 11/01/2010
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Provider Practice Location Address
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Address Line | 107 NORTHERN BLVD STE 206
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City | GREAT NECK
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State | NY
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Zip | 11021-4309
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Country | US
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Telephone | 516-829-3376
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Fax | 516-829-2019
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Provider Business Mailing Address
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Address Line | 10845 65TH AVE
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City | FOREST HILLS
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State | NY
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Zip | 11375-1419
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Country | US
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Telephone | 917-526-8498
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Fax |
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Authorized Official
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Title or Position | DERMATOLOGIST
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Name | MICHAEL PALTIEL
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Credential | M.D.
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Telephone | 917-526-8498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 245541
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License Number State | NY
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