Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N002997 | NY |
NPI | 1174614630 |
---|---|
Provider Name | Dr. Michael L Tumen |
First Address | Massapequa, NY 11758-6001 |
Second Address | Massapequa, NY 11758-6001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 22/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T71-176 | (02) | NY |