Provider Demographics
NPI:1053305516
Name:TIGHE, MICHAEL JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:TIGHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 NEW YORK BLVD
Mailing Address - Street 2:
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-2015
Mailing Address - Country:US
Mailing Address - Phone:732-449-0698
Mailing Address - Fax:732-449-0698
Practice Address - Street 1:309 NEW YORK BLVD
Practice Address - Street 2:
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-2015
Practice Address - Country:US
Practice Address - Phone:732-449-0698
Practice Address - Fax:732-449-0698
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02238500207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ433909QKFMedicare ID - Type Unspecified
C53924Medicare UPIN