Provider Demographics
NPI:1164584553
Name:TREPETA, MICHAEL FRANCIS (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FRANCIS
Last Name:TREPETA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-0360
Mailing Address - Country:US
Mailing Address - Phone:515-374-6838
Mailing Address - Fax:516-374-2362
Practice Address - Street 1:115 EILEEN WAY
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-5302
Practice Address - Country:US
Practice Address - Phone:516-795-3033
Practice Address - Fax:516-590-7684
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212833207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02236859Medicaid
NYH33016Medicare ID - Type Unspecified
NYH33016Medicare UPIN