Individual
DR. MICHAEL BRIAN SISTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
710 W 168TH ST, NEW YORK, NY 10032-3726
(212) 305-1728
(212) 305-3629
Mailing address
710 W 168TH ST, NEW YORK, NY 10032-3726
(212) 305-1728
(212) 305-3629
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
161742
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01075901
—
NY
05
—
1649809
—
NJ
Enumeration date
06/30/2006
Last updated
07/08/2007
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