Individual
DR. MICHAEL NISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1317 3RD AVE, FIRST FLOOR, NEW YORK, NY 10021-2995
(212) 772-7000
(212) 772-7001
Mailing address
240 E 82ND ST, APT. 6J, NEW YORK, NY 10028-2703
(212) 772-7000
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
188503
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01755637
—
NY
01
—
0401390
GHI
NY
01
—
134174737
EMPIRE BLUE CR/BLUE SH
NY
01
—
161012
ELDERPLAN
NY
01
—
188503B34
HEALTH FIRST
NY
01
—
2448242
AETNA USHEALTHCARE
NY
01
—
434294P
HIP
NY
01
—
46350C
MAGNACARE
NY
01
—
4987173005
CIGNA
NY
01
—
P865763
OXFORD
NY
Enumeration date
07/14/2005
Last updated
07/30/2012
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