Provider Demographics
NPI:1881888584
Name:CRAIG ANTELL, D.O.,P.C.
Entity type:Organization
Organization Name:CRAIG ANTELL, D.O.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:212-685-1666
Mailing Address - Street 1:274 MADISON AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0701
Mailing Address - Country:US
Mailing Address - Phone:212-685-1666
Mailing Address - Fax:212-685-8612
Practice Address - Street 1:274 MADISON AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0701
Practice Address - Country:US
Practice Address - Phone:212-685-1666
Practice Address - Fax:212-685-8612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWFW021Medicare PIN
NYWFW023Medicare PIN