Provider Demographics
NPI:1235166349
Name:BILKIS, MICHAEL R (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:R
Last Name:BILKIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 POMTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044
Mailing Address - Country:US
Mailing Address - Phone:973-571-2121
Mailing Address - Fax:973-571-2126
Practice Address - Street 1:60 POMTON AVENUE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044
Practice Address - Country:US
Practice Address - Phone:973-571-2121
Practice Address - Fax:973-571-2126
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05571300207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1235166349OtherPROVIDER ID
NJ653958OtherMEDICARE PIN
NJ653958Medicare PIN
NJ653958OtherMEDICARE PIN