Provider Demographics
NPI:1689628737
Name:BARTOL, DAVID (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:BARTOL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 JANES LN
Mailing Address - Street 2:
Mailing Address - City:LLOYD HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11743-1715
Mailing Address - Country:US
Mailing Address - Phone:914-649-4700
Mailing Address - Fax:
Practice Address - Street 1:1408 OCEAN AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-3803
Practice Address - Country:US
Practice Address - Phone:718-338-0909
Practice Address - Fax:718-258-4713
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005788213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPH4242OtherBLUE CROSS
NY02264377Medicaid
NYU90164Medicare UPIN
NYPG9331Medicare ID - Type Unspecified
NY02264377Medicaid