Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 101727 | NY |
NPI | 1013902220 |
---|---|
Provider Name | Mr. Michael A Consiglio |
First Address | Hewlett, NY 11557-1744 |
Second Address | Hewlett, NY 11557-1744 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 17/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B16718 | (02) |