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NPI Code Detail

MEDICARE: DR. MARTIN MATSIL BEITLER MD

MEDICARE: DR. MARTIN MATSIL BEITLER 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
1207R00000XInternal Medicine Physician169132NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1E17708OTHERNYUPIN

General Provider Information

NPI Number : 1265573372
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARTIN MATSIL BEITLER MD
Provider Business Mailing Address
First Line : 153 W 27TH ST
Second Line : SUITE 301
City : NEW YORK
State : NY
Zip : 10001-6203
Country : US
Telephone Number : 212-627-1222
Fax Number : 212-462-4130
Provider Business Practice Location Address
First Line : 153 W 27TH ST
Second Line : SUITE 301
City : NEW YORK
State : NY
Zip : 10001-6203
Country : US
Telephone Number : 212-627-1222
Fax Number : 212-462-4130
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2007
Last Update Date : 10/27/2016

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