Organization
MICHAEL W. ELICE MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL W. ELICE MD (MEDICAL DIRECTOR)
(506) 802-5028
Entity
Organization
Contact information
Practice address
80 CROSSWAYS PARK DR, SUITE 200, WOODBURY, NY 11797-2047
(516) 802-5028
(516) 802-5027
Mailing address
80 CROSSWAYS PARK DR, SUITE 200, WOODBURY, NY 11797-2047
(516) 802-5028
(516) 802-5027
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
1325791
NY
Other
Enumeration date
12/05/2014
Last updated
12/05/2014
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