Provider Demographics
NPI:1588734735
Name:ANTELL, DAVID JEFFREY (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JEFFREY
Last Name:ANTELL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:143 FROEHLICH FARM BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-2906
Mailing Address - Country:US
Mailing Address - Phone:516-390-8888
Mailing Address - Fax:516-364-4767
Practice Address - Street 1:143 FROEHLICH FARM BLVD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-2906
Practice Address - Country:US
Practice Address - Phone:516-390-8888
Practice Address - Fax:516-364-4767
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2024-05-17
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Provider Licenses
StateLicense IDTaxonomies
NY193121208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG67048Medicare UPIN