Provider Demographics
NPI:1629142849
Name:MOLAEI, MICHAEL MOSTAFA (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MOSTAFA
Last Name:MOLAEI
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 1:800 2ND AVE
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4709
Mailing Address - Country:US
Mailing Address - Phone:212-686-6066
Mailing Address - Fax:212-779-7724
Practice Address - Street 1:800 2ND AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4709
Practice Address - Country:US
Practice Address - Phone:212-686-6066
Practice Address - Fax:212-779-7724
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191080207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4598449OtherAETNA
NY7206703OtherCIGNA
NY01502372Medicaid
NY191080N01OtherHIP
NY82N692OtherBLUE CROSS BLUE SHIELD
NY1000024543OtherAFFINITY
NY1167617OtherUNITED HEALTHCARE
NYP2590317OtherOXFORD
NY0203586OtherGHI
NY0203586OtherGHI