Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 243107 | NY |
NPI | 1023208543 |
---|---|
Provider Name | Dr. Michael Joseph Sileo |
First Address | East Setauket, NY 11733-4079 |
Second Address | East Setauket, NY 11733-4079 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2007 |
Last Update Date | 18/03/2019 |