Provider Demographics
NPI:1508837170
Name:WITZEL, DAVID MARC (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARC
Last Name:WITZEL
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:CAREMOUNT MEDICAL PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:22 GREEN ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1306
Practice Address - Country:US
Practice Address - Phone:845-231-5600
Practice Address - Fax:845-471-9516
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220786207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02312150Medicaid
NYH72315Medicare UPIN
NY02312150Medicaid
NYA400116351Medicare PIN