Provider Demographics
NPI:1376548818
Name:MADIGAN, MICHAEL CHRISTOPHER (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHRISTOPHER
Last Name:MADIGAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6805 ROUTE 9
Mailing Address - Street 2:STE 27
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1160
Mailing Address - Country:US
Mailing Address - Phone:845-876-2222
Mailing Address - Fax:
Practice Address - Street 1:6805 ROUTE 9
Practice Address - Street 2:STE 27
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1160
Practice Address - Country:US
Practice Address - Phone:845-876-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT 005829152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU73751Medicare UPIN