Organization
MARCO K MICHELSON, MD, PC
Active
Organization
MARCO K MICHELSON, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCO K MICHELSON MD (PRESIDENT)
(917) 771-2111
Entity
Organization
Contact information
Practice address
1051 PORT WASHINGTON BLVD, NO 766, PORT WASHINGTON, NY 11050-2941
(917) 771-2111
Mailing address
PO BOX 766, PORT WASHINGTON, NY 11050-0766
(917) 771-2111
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
188110
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01366912
—
NY
Enumeration date
06/30/2008
Last updated
04/09/2009
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