Provider Demographics
NPI:1104083245
Name:NAGEL, DALIA SHORETZ (MD)
Entity type:Individual
Prefix:DR
First Name:DALIA
Middle Name:SHORETZ
Last Name:NAGEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1249 PARK AVE APT 6F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-7211
Mailing Address - Country:US
Mailing Address - Phone:917-723-9696
Mailing Address - Fax:
Practice Address - Street 1:229 E 79TH ST STE 1L
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0866
Practice Address - Country:US
Practice Address - Phone:212-861-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240715207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology