Provider Demographics
NPI:1093884645
Name:BETZLER, THOMAS F (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:F
Last Name:BETZLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 BISHOP RD
Mailing Address - Street 2:36 BISHOP RD.
Mailing Address - City:BEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10506-1606
Mailing Address - Country:US
Mailing Address - Phone:718-904-4415
Mailing Address - Fax:718-931-7307
Practice Address - Street 1:2527 GLEBE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3109
Practice Address - Country:US
Practice Address - Phone:718-904-4415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1688452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry