Provider Demographics
NPI:1134142714
Name:BUCHALTER, JOEL S (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:S
Last Name:BUCHALTER
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 1:664 STONELEIGH AVE
Mailing Address - Street 2:STE 300 SOMERS ORTHOPAEDIC SURGERY AND SPORTS MED GR PL
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-3940
Mailing Address - Country:US
Mailing Address - Phone:845-278-8400
Mailing Address - Fax:845-278-4326
Practice Address - Street 1:664 STONELEIGH AVE
Practice Address - Street 2:STE 300 SOMERS ORTHOPAEDIC SURGERY AND SPORTS MED GR PL
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-3940
Practice Address - Country:US
Practice Address - Phone:845-278-8400
Practice Address - Fax:845-278-4326
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT29668174400000X
NY158554174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00017657OtherRAILROAD MEDICARE
NY200045589OtherRAILROAD MEDICARE
NY4682510003Medicare NSC
NY4682510004Medicare NSC
NY200045589OtherRAILROAD MEDICARE
NY4682510001Medicare NSC
NY22E281Medicare PIN