Provider Demographics
NPI:1720235153
Name:WALTER A BESSER,PC
Entity Type:Organization
Organization Name:WALTER A BESSER,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:A
Authorized Official - Last Name:BESSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-204-7752
Mailing Address - Street 1:3071 29TH ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-2756
Mailing Address - Country:US
Mailing Address - Phone:718-204-7752
Mailing Address - Fax:718-721-9248
Practice Address - Street 1:3071 29TH ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2756
Practice Address - Country:US
Practice Address - Phone:718-204-7752
Practice Address - Fax:718-721-9248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114623207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00635841Medicaid
NY00635841Medicaid
NY4989DQMedicare UPIN
NYB18824Medicare UPIN