MEDICARE: MARIE BACHTHALER KEITH M.D.

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	208000000X	Pediatrics Physician	128244	NY

General Provider Information

NPI Number	:	1457438616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE BACHTHALER KEITH M.D.

Provider Business Mailing Address
First Line	:	552 BROADWAY
Second Line	:	5TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10012-3922
Country	:	US
Telephone Number	:	212-334-3366
Fax Number	:	212-334-3981

Provider Business Practice Location Address
First Line	:	552 BROADWAY
Second Line	:	5TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10012-3922
Country	:	US
Telephone Number	:	212-334-3366
Fax Number	:	212-334-3981

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1750535936 — PROMOBILITY PHYSICAL THERAPY, P.C.
Practice Location Address:

552 BROADWAY STE 502
NEW YORK, NY
10012-3922

Practice Phone: 917-757-5135
Practice Fax: 917-522-9623

1508137290 — SOHO PEDIATRIC GROUP
Practice Location Address:

552 BROADWAY , 5N
NEW YORK, NY
10012-3922

Practice Phone: 212-334-3366
Practice Fax: 212-334-3981

1235549452 — PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC
Practice Location Address:

552 BROADWAY , 4TH FLOOR
NEW YORK, NY
10012-3922

Practice Phone: 212-226-6704
Practice Fax: 212-226-8207

1083007330 — DR. ANTHONY LEONETTI DMD
Practice Location Address:

552 BROADWAY STE 505
NEW YORK, NY
10012-3922

Practice Phone: 212-878-7646
Practice Fax:

1144776592 — ERIC CHAN
Practice Location Address:

552 BROADWAY , 4TH FLOOR
NEW YORK, NY
10012-3922

Practice Phone: 212-226-6704
Practice Fax: 212-226-8207

1972053544 — PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC
Practice Location Address:

552 BROADWAY FL 4
NEW YORK, NY
10012-3922

Practice Phone: 212-226-6704
Practice Fax: 212-226-8207

Directions to “ MARIE BACHTHALER KEITH M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.