Individual
MARCO K MICHELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
188110
NY
Other
Enumeration date
10/21/2008
Last updated
04/09/2009
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