Provider Demographics
NPI:1205006921
Name:MICHAEL L TUMEN DPM
Entity Type:Organization
Organization Name:MICHAEL L TUMEN DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:TUMEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-541-1591
Mailing Address - Street 1:4333 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-6001
Mailing Address - Country:US
Mailing Address - Phone:516-541-1591
Mailing Address - Fax:
Practice Address - Street 1:4333 MERRICK RD
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-6001
Practice Address - Country:US
Practice Address - Phone:516-541-1591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002997332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0557230001Medicare NSC