Provider Demographics
NPI:1538167648
Name:ALTMAN, DARYL R (MD)
Entity type:Individual
Prefix:DR
First Name:DARYL
Middle Name:R
Last Name:ALTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:120 BETHPAGE RD STE 310
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-1515
Mailing Address - Country:US
Mailing Address - Phone:516-822-6655
Mailing Address - Fax:516-932-2090
Practice Address - Street 1:120 BETHPAGE RD STE 310
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-1515
Practice Address - Country:US
Practice Address - Phone:516-822-6655
Practice Address - Fax:516-932-2090
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY155382207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00990152Medicaid
NYE44974Medicare UPIN