Provider Demographics
NPI:1679598445
Name:WATNIK, NEIL F (MD)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:F
Last Name:WATNIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:410 LAKEVILLE ROAD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1120
Mailing Address - Country:US
Mailing Address - Phone:516-775-7898
Mailing Address - Fax:516-775-4796
Practice Address - Street 1:410 LAKEVILLE ROAD
Practice Address - Street 2:SUITE 303
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1120
Practice Address - Country:US
Practice Address - Phone:516-775-7898
Practice Address - Fax:516-775-4796
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1746691207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
E98550Medicare UPIN
98F261Medicare ID - Type Unspecified