Provider Demographics
NPI:1982267464
Name:BREITLING, MAY THEL (MD)
Entity Type:Individual
Prefix:
First Name:MAY
Middle Name:THEL
Last Name:BREITLING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MAY
Other - Middle Name:THEL
Other - Last Name:SU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1468 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6508
Mailing Address - Country:US
Mailing Address - Phone:212-241-6500
Mailing Address - Fax:
Practice Address - Street 1:355 BARD AVENUE
Practice Address - Street 2:DEPARTMENT OF MEDICINE VILLA BLDG 1ST FLOOR
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310
Practice Address - Country:US
Practice Address - Phone:718-818-2419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2022-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317904207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine