Provider Demographics
NPI:1497864052
Name:MACRI, MICHAEL VINCENT (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:VINCENT
Last Name:MACRI
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 1:10 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-2225
Mailing Address - Country:US
Mailing Address - Phone:201-358-2922
Mailing Address - Fax:201-358-9540
Practice Address - Street 1:10 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-2225
Practice Address - Country:US
Practice Address - Phone:201-358-2922
Practice Address - Fax:201-358-9540
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
6329877OtherCIGNA
F12689OtherHEALTH NET
PP212OtherOXFORD
0110500OtherGHI PPO
936984OtherAETNA HMO
4508781OtherAETNA PPO
NJ097519Medicare ID - Type Unspecified
0110500OtherGHI PPO