Provider Demographics
NPI:1558669101
Name:NESLINE, MICHAEL J (RN)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:NESLINE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:MICHAEL
Other - Middle Name:J
Other - Last Name:NESLINE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:83 MAIDEN LANE 6TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4812
Mailing Address - Country:US
Mailing Address - Phone:212-780-2378
Mailing Address - Fax:212-505-0724
Practice Address - Street 1:83 MAIDEN LANE 6TH FLOOR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4812
Practice Address - Country:US
Practice Address - Phone:212-780-2378
Practice Address - Fax:212-505-0724
Is Sole Proprietor?:No
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY412833163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse