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General NPI Number Information
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NPI Number | 1396929402
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Entity Type | Organization
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Legal Business Name | PAUL S PICKHOLTZ MD PC
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Dates
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Enumeration Date | 12/26/2007
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Last Update Date | 12/26/2007
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Provider Practice Location Address
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Address Line | 970 N BROADWAY SUITE 304
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City | YONKERS
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State | NY
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Zip | 10701
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Country | US
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Telephone | 914-969-5501
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Fax | 914-969-2238
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Provider Business Mailing Address
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Address Line | 21 KELLER LANE
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City | DOBBS FERRY
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State | NY
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Zip | 10522
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Country | US
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Telephone | 914-693-7046
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL S PICKHOLTZ
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Credential | MD
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Telephone | 914-969-5501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 114497
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License Number State | NY
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