Individual
MR. NIEL J SQUILLANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12 SMITH FARM RD, BEDFORD, NY 10506-2030
(914) 419-3554
(914) 234-0230
Mailing address
12 SMITH FARM RD, BEDFORD, NY 10506-2030
(914) 419-3554
(914) 234-0230
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
104042
NY
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
104042
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00180772
—
NY
05
—
02663885
—
NY
Enumeration date
09/28/2006
Last updated
10/24/2022
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