Provider Demographics
NPI:1083745350
Name:MICHAEL V. MACRI, M.D., P.C.
Entity Type:Organization
Organization Name:MICHAEL V. MACRI, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:MACRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-358-2922
Mailing Address - Street 1:10 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-2225
Mailing Address - Country:US
Mailing Address - Phone:201-358-2922
Mailing Address - Fax:201-358-9540
Practice Address - Street 1:10 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-2225
Practice Address - Country:US
Practice Address - Phone:201-358-2922
Practice Address - Fax:201-358-9540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F43513Medicare UPIN
NJ097519Medicare ID - Type Unspecified