Individual
RAYMOND DATTWYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 PARK AVE, HUNTINGTON, NY 11743-2779
(631) 659-4491
(631) 659-4580
Mailing address
325 PARK AVE, HUNTINGTON, NY 11743-2779
(631) 659-4491
(631) 659-4580
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
145814
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000090207
GHI HMO
NY
05
—
00662840
—
NY
01
—
133277785
TRICARE
—
01
—
145814
HIP
NY
01
—
145814
HIP
—
01
—
2099746
GHI PPO
NY
01
—
3738401
AETNA HMO
NY
01
—
389284
MVP
NY
01
—
3C7116
HEALTHNET
NY
01
—
4589993
AETNA PPO
NY
01
—
DR5814
ATLANTIS
—
01
—
P3453285
OXFORD
—
Enumeration date
07/26/2006
Last updated
11/30/2015
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