Provider Demographics
NPI:1164437950
Name:DOSIK, MICHAEL H (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:DOSIK
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 1:22 CONSCIENCE CIR
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3106
Mailing Address - Country:US
Mailing Address - Phone:631-751-5421
Mailing Address - Fax:631-751-7452
Practice Address - Street 1:22 CONSCIENCE CIR
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3106
Practice Address - Country:US
Practice Address - Phone:631-751-5421
Practice Address - Fax:631-751-7452
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114608207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4260593OtherAETNA
NY00679814Medicaid
NY11-2419534OtherMAGNACARE
NY0791K3OtherEMPIRE BS
NY11-2419534OtherMAGNACARE
NYC11938Medicare UPIN