Provider Demographics
NPI:1134142714
Name:BUCHALTER, JOEL S (MD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:S
Last Name:BUCHALTER
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 1:40 OLD RIDGEBURY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5123
Mailing Address - Country:US
Mailing Address - Phone:203-397-6872
Mailing Address - Fax:203-207-0304
Practice Address - Street 1:664 STONELEIGH AVE
Practice Address - Street 2:STE 300 SOMERS ORTHOPAEDIC SURGERY AND SPORTS MED GR PL
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-3940
Practice Address - Country:US
Practice Address - Phone:845-278-8400
Practice Address - Fax:845-278-4326
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT29668207X00000X, 174400000X
NY158554207X00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00017657OtherRAILROAD MEDICARE
NY200045589OtherRAILROAD MEDICARE
NY4682510003Medicare NSC
NY4682510004Medicare NSC
NY200045589OtherRAILROAD MEDICARE
NY4682510001Medicare NSC
NY22E281Medicare PIN