Provider Demographics
NPI:1114974490
Name:ALTCHEK, DAVID W (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:ALTCHEK
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 1:610 W 58TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1005
Mailing Address - Country:US
Mailing Address - Phone:212-606-1909
Mailing Address - Fax:212-879-6526
Practice Address - Street 1:610 W 58TH ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1005
Practice Address - Country:US
Practice Address - Phone:212-606-1909
Practice Address - Fax:212-879-6526
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1713331174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME137808OtherORTHOPEDIC
NY171333OtherORTHOPEDIC / SPORTS MEDICINE