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Individual
MICHAEL DISALLE
Active
Individual
MICHAEL DISALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
197073
NY
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
197073
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01658608
—
NY
01
—
110225075
MEDICAID RR
—
Enumeration date
06/27/2006
Last updated
03/28/2015
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