Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 203112 | NY |
NPI | 1013004530 |
---|---|
Provider Name | Dr. Michael Zilles |
First Address | Hawthorne, NY 10532-2140 |
Second Address | Fishkill, NY 12524-2271 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 06/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89128YW | (05) | NC |
H36531 | (02) |