Provider Demographics
NPI:1194819383
Name:GINSBURG, MICHAEL M (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:M
Last Name:GINSBURG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:1637 MADISON PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1822
Mailing Address - Country:US
Mailing Address - Phone:718-375-2942
Mailing Address - Fax:718-981-0103
Practice Address - Street 1:11 RALPH PL
Practice Address - Street 2:SUITE 304
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4419
Practice Address - Country:US
Practice Address - Phone:718-981-0100
Practice Address - Fax:718-981-0103
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN005785-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02265929Medicaid
NY02265929Medicaid
4702300001Medicare NSC
NYPG7712Medicare PIN