Individual
DR. NATHAN KEELER MICKINAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2000
Mailing address
270 1ST ST APT 3A, MINEOLA, NY 11501-2362
(304) 904-5734
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
303914
NY
Other
Enumeration date
03/26/2018
Last updated
05/18/2023
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