Individual
ANTONELA MICCOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
79-01 BROADWAY, NEW YORK CITY, NY 11373
(718) 334-2156
Mailing address
79-01 BROADWAY, NEW YORK CITY, NY 11373
(718) 334-2156
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/07/2021
Last updated
07/07/2021
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