Provider Demographics
NPI:1295194454
Name:OAKES, MICHAEL HAEJOON (DPT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:HAEJOON
Last Name:OAKES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 MADISON AVE.
Mailing Address - Street 2:STE1304
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5757
Mailing Address - Country:US
Mailing Address - Phone:917-715-4665
Mailing Address - Fax:718-744-9234
Practice Address - Street 1:315 MADISON AVE.
Practice Address - Street 2:STE1304
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5757
Practice Address - Country:US
Practice Address - Phone:917-715-4665
Practice Address - Fax:718-744-9234
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039879-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist