MEDICARE: DR. CRAIG ANTELL D.O.

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	208100000X	Physical Medicine & Rehabilitation Physician	2094506	NY

General Provider Information

NPI Number	:	1164546537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG ANTELL D.O.

Provider Business Mailing Address
First Line	:	57 W 57TH ST
Second Line	:	SUITE 1702
City	:	NEW YORK
State	:	NY
Zip	:	10019-2802
Country	:	US
Telephone Number	:	212-757-1157
Fax Number	:	212-757-7197

Provider Business Practice Location Address
First Line	:	57 W 57TH ST
Second Line	:	SUITE 1702
City	:	NEW YORK
State	:	NY
Zip	:	10019-2802
Country	:	US
Telephone Number	:	212-757-1157
Fax Number	:	212-757-7197

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	06/08/2021

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