Provider Demographics
NPI:1609860121
Name:CAMMARATA, MICHELLE (DO)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:CAMMARATA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5441 WEYHILL LN
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-8701
Mailing Address - Country:US
Mailing Address - Phone:617-204-3500
Mailing Address - Fax:617-517-9155
Practice Address - Street 1:5441 WEYHILL LN
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-8701
Practice Address - Country:US
Practice Address - Phone:617-204-3500
Practice Address - Fax:617-517-9155
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220684207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH63678Medicare UPIN
NY47V661Medicare ID - Type Unspecified