Provider Demographics
NPI:1083735104
Name:MAKOWSKY, MICHAEL JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:MAKOWSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:M.
Other - Middle Name:J
Other - Last Name:MAKOWSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:301 SULLIVAN WAY
Mailing Address - Street 2:
Mailing Address - City:WEST TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-3406
Mailing Address - Country:US
Mailing Address - Phone:609-883-1300
Mailing Address - Fax:609-493-1705
Practice Address - Street 1:301 SULLIVAN WAY
Practice Address - Street 2:
Practice Address - City:WEST TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08628-3406
Practice Address - Country:US
Practice Address - Phone:609-883-1300
Practice Address - Fax:609-493-1705
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMAO63023174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist