DR. MICHAEL NUSSBAUM M.D. NPI 1356458442

NPI Information

  • NPI: 1356458442
  • Provider Name: DR. MICHAEL NUSSBAUM, M.D.
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Individual
  • Address: 270 UNION AVE
    HOLBROOK, NY
    ZIP 11741
  • Phone: (631) 588-4442

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NPI Details

DR. Michael Nussbaum, M.D. is an adolescent medicine pediatrics in Holbrook, NY. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. DR. Michael Nussbaum, M.D. NPI is 1356458442. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

270 UNION AVE
HOLBROOK, NY
ZIP 11741-823
Phone: (631) 588-4442

The enumeration date for this NPI number is 8/24/2006 and was last updated on 11/22/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080A0000XPediatricsAdolescent Medicine124424NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100306170MEDICAIDNEW YORK
2D72555MEDICARE UPINNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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