Provider Demographics
NPI:1417114679
Name:MICHEL F MOULIN, MD AND L. NICOLE MOULIN, MD PC
Entity Type:Organization
Organization Name:MICHEL F MOULIN, MD AND L. NICOLE MOULIN, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOULIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-832-0550
Mailing Address - Street 1:210 E 47TH ST
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-2108
Mailing Address - Country:US
Mailing Address - Phone:212-832-0550
Mailing Address - Fax:212-829-7002
Practice Address - Street 1:210 E 47TH ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-2108
Practice Address - Country:US
Practice Address - Phone:212-832-0550
Practice Address - Fax:212-829-7002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY134945207W00000X
NY143416207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty