Individual
JERRY C. WACHTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8605 FLATLANDS AVE, BROOKLYN, NY 11236-3607
(718) 257-1500
(718) 257-6114
Mailing address
8605 FLATLANDS AVE, BROOKLYN, NY 11236-3607
(718) 257-1500
(718) 257-6114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
161249
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01014126
—
NY
Enumeration date
12/06/2007
Last updated
05/29/2008
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