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General NPI Number Information
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NPI Number | 1821525742
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Entity Type | Organization
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Legal Business Name | CHELSEA OTOLARYNGOLOGY PLLC
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Dates
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Enumeration Date | 05/23/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 160 W 18TH ST
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City | NEW YORK
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State | NY
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Zip | 10011-5403
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Country | US
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Telephone | 212-366-0848
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Fax | 212-366-0847
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Provider Business Mailing Address
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Address Line | 160 W 18TH ST
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City | NEW YORK
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State | NY
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Zip | 10011-5403
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Country | US
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Telephone | 212-366-0848
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Fax | 212-366-0847
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Authorized Official
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Title or Position | MD
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Name | WILLIAM M PORTNOY
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Credential | MD
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Telephone | 212-366-0848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 175480
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License Number State | NY
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