Provider Demographics
NPI:1568769172
Name:MICHAEL J. DALTO M.D. P.C.
Entity Type:Organization
Organization Name:MICHAEL J. DALTO M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DALTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-636-1333
Mailing Address - Street 1:20 PLAZA STREET EAST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4955
Mailing Address - Country:US
Mailing Address - Phone:718-636-1333
Mailing Address - Fax:718-622-5832
Practice Address - Street 1:20 PLAZA STREET EAST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4955
Practice Address - Country:US
Practice Address - Phone:718-636-1333
Practice Address - Fax:718-622-5832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-16
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY125033207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC08173Medicare UPIN
NY309201Medicare PIN