Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 093082 | NY |
NPI | 1013085471 |
---|---|
Provider Name | Dr. Michael Frank Michelis |
First Address | New York, NY 10021-1851 |
Second Address | New York, NY 10021-1851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 29/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C11818 | (02) | NY |