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General NPI Number Information
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NPI Number | 1558220848
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Entity Type | Organization
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Legal Business Name | DR MARK HALTRECHT PLLC
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Dates
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Enumeration Date | 01/21/2026
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 6061 MAIN ST
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City | TANNERSVILLE
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State | NY
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Zip | 12485-7717
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Country | US
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Telephone | 516-867-5132
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Fax | 516-867-5519
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Provider Business Mailing Address
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Address Line | PO BOX 134
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City | HUNTER
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State | NY
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Zip | 12442-0134
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Country | US
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Telephone | 516-754-5279
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARK HALTRECHT
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Credential | DO
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Telephone | 516-754-5279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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