Individual
MICHAEL M AMZALLAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 E 77TH ST, NEW YORK, NY 10021-1850
(212) 434-2878
Mailing address
PO BOX 26642, NEW YORK, NY 10087-6642
(201) 804-2800
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
144386-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00865132
—
NY
Enumeration date
06/23/2005
Last updated
07/08/2007
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