Provider Demographics
NPI:1144752668
Name:WACHTEL, JONATHAN MILLER (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:MILLER
Last Name:WACHTEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:34 S BROADWAY STE 702
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4427
Mailing Address - Country:US
Mailing Address - Phone:914-428-8563
Mailing Address - Fax:914-686-0933
Practice Address - Street 1:34 S BROADWAY STE 702
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4427
Practice Address - Country:US
Practice Address - Phone:914-428-8563
Practice Address - Fax:914-686-0933
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-03
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY3031032084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry