MEDICARE: ORLI R ETINGIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	146398	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154418234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ORLI R ETINGIN MD

Provider Business Mailing Address
First Line	:	1315 YORK AVE # 1
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-5304
Country	:	US
Telephone Number	:	212-746-0373
Fax Number	:	212-746-7481

Provider Business Practice Location Address
First Line	:	1315 YORK AVE # 1
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-5304
Country	:	US
Telephone Number	:	212-746-2066
Fax Number	:	212-746-3305

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	09/14/2011

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Directions to “ ORLI R ETINGIN MD” Practice Location

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