Provider Demographics
NPI:1023034766
Name:BUCHALTER, ERIC NEAL (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:NEAL
Last Name:BUCHALTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 MINEOLA BLVD
Mailing Address - Street 2:SUITE301
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2528
Mailing Address - Country:US
Mailing Address - Phone:516-741-4111
Mailing Address - Fax:
Practice Address - Street 1:173 MINEOLA BLVD
Practice Address - Street 2:SUITE301
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2528
Practice Address - Country:US
Practice Address - Phone:516-741-4111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1827042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6100287OtherEMP &GHI
NYP954116OtherOXFORD
NY6100287OtherEMP &GHI
NYP954116OtherOXFORD