Provider Demographics
NPI:1164682522
Name:KAISER, MICHELLE ESTILO (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ESTILO
Last Name:KAISER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:JOSEFINA
Other - Last Name:ESTILO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2 STRATFORD LN
Mailing Address - Street 2:
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423-1715
Mailing Address - Country:US
Mailing Address - Phone:201-652-1232
Mailing Address - Fax:
Practice Address - Street 1:2 STRATFORD LN
Practice Address - Street 2:
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1715
Practice Address - Country:US
Practice Address - Phone:201-652-1232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214660207R00000X
NJ25MA07685600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine