Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 124472 | NY |
NPI | 1013924679 |
---|---|
Provider Name | Robert R. Michiel |
First Address | Syracuse, NY 13202-2240 |
Second Address | Syracuse, NY 13202-2240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 16/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00411385 | (05) | NY |