Provider Demographics
NPI:1760651764
Name:RICHARD H. NACHTIGALL M.D. AND LILA E. NACHTIGALL M.D., P.C.
Entity Type:Organization
Organization Name:RICHARD H. NACHTIGALL M.D. AND LILA E. NACHTIGALL M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:NACHTIGALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-355-7667
Mailing Address - Street 1:251 E 33RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4804
Mailing Address - Country:US
Mailing Address - Phone:212-355-7667
Mailing Address - Fax:212-779-8431
Practice Address - Street 1:251 E 33RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4804
Practice Address - Country:US
Practice Address - Phone:212-355-7667
Practice Address - Fax:212-779-8431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081041207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY120891Medicare PIN