Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 25MD00346200 | NJ |
NPI | 1033565452 |
---|---|
Provider Name | Michael Milad |
First Address | Sayreville, NJ 08872-1655 |
Second Address | Bayonne, NJ 07002-5105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2016 |
Last Update Date | 03/11/2020 |