Provider Demographics
NPI:1053475731
Name:PREISS-LOWENWIRT, MICHELLE FRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:FRAN
Last Name:PREISS-LOWENWIRT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:FRAN
Other - Last Name:PREISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:18428 MIDLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1528
Mailing Address - Country:US
Mailing Address - Phone:718-591-0830
Mailing Address - Fax:718-793-2023
Practice Address - Street 1:7210 112TH ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5467
Practice Address - Country:US
Practice Address - Phone:718-793-5410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1727002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE38685Medicare UPIN