Provider Demographics
NPI:1518991835
Name:BEYTELMAN, MAYOR (MD)
Entity Type:Individual
Prefix:
First Name:MAYOR
Middle Name:
Last Name:BEYTELMAN
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 1:201 E 19TH ST APT 9L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2626
Mailing Address - Country:US
Mailing Address - Phone:718-377-2000
Mailing Address - Fax:
Practice Address - Street 1:201 E 19TH ST APT 9L
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2626
Practice Address - Country:US
Practice Address - Phone:718-377-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1508372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00730272Medicaid
NY75A801Medicare ID - Type Unspecified
B19199Medicare UPIN