Provider Demographics
NPI:1225474323
Name:MICHAEL R. MILANO MD PC
Entity Type:Organization
Organization Name:MICHAEL R. MILANO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:V
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-837-6553
Mailing Address - Street 1:141 AYERS CT
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-5160
Mailing Address - Country:US
Mailing Address - Phone:201-837-6553
Mailing Address - Fax:201-837-6551
Practice Address - Street 1:141 AYERS CT
Practice Address - Street 2:SUITE 2C
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-5160
Practice Address - Country:US
Practice Address - Phone:201-837-6553
Practice Address - Fax:201-837-6551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA023757002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0806005Medicaid
NJ447096Medicare PIN