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General NPI Number Information
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NPI Number | 1174706592
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Entity Type | Organization
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Legal Business Name | DAVID J. ANTELL, D.O, PC
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 329 E 18TH ST
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City | NEW YORK
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State | NY
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Zip | 10003-2844
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Country | US
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Telephone | 212-673-0788
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Fax | 212-533-8623
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Provider Business Mailing Address
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Address Line | 329 E 18TH ST
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City | NEW YORK
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State | NY
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Zip | 10003-2844
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Country | US
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Telephone | 212-673-0788
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Fax | 212-533-8623
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID J. ANTELL
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Credential | D.O
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Telephone | 212-673-0788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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