Provider Demographics
NPI:1053496372
Name:LOVE, MICHELLE H (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:H
Last Name:LOVE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:79 MADISON AVENUE
Mailing Address - Street 2:6TH FLOOR COMMUNITY HEALTHCARE NETWORK INC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-545-2400
Mailing Address - Fax:646-312-0481
Practice Address - Street 1:81 WEST 115TH STREET
Practice Address - Street 2:HELEN B ATKINSON HEALTH CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026
Practice Address - Country:US
Practice Address - Phone:212-426-0088
Practice Address - Fax:212-426-8367
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2014-04-01
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Provider Licenses
StateLicense IDTaxonomies
NY227546207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY331945Medicare PIN
NY00695941Medicaid