PROF. CHARLES KENNETH MICELI MD NPI 1528057353

NPI Information

NPI: 1528057353
Provider Name: PROF. CHARLES KENNETH MICELI, MD
Classification: Internal Medicine - 207RI0011X
Entity Type: Individual

Specialization: Interventional Cardiology

Address:
585 BROADWAY
MASSAPEQUA, NY
ZIP 11758
Phone: (516) 797-1234
Get Directions

PROF. Charles Kenneth Miceli, MD is an interventional cardiology internal medicine in Massapequa, NY. The provider is an area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. PROF. Charles Kenneth Miceli, MD NPI is 1528057353. 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:

585 BROADWAY
MASSAPEQUA, NY
ZIP 11758-023
Phone: (516) 797-1234
Fax: (516) 797-1932

The enumeration date for this NPI number is 10/14/2005 and was last updated on 9/28/2007.

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
1	207RI0011X	Internal Medicine	Interventional Cardiology	130596	NEW YORK	Yes

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
1	B73321	MEDICARE UPIN
2	05A601	MEDICARE ID-TYPE UNSPECIFIED
3	00409210	MEDICAID	NEW 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: 5/5/2024

NPI Synchronization or Removal

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