Provider Demographics
NPI:1669447108
Name:CILIP, MICHAEL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:CILIP
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10783 HIDDEN MEADOW TRL
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-9495
Mailing Address - Country:US
Mailing Address - Phone:607-368-7095
Mailing Address - Fax:607-973-2309
Practice Address - Street 1:23 W MARKET ST STE 101
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2600
Practice Address - Country:US
Practice Address - Phone:607-846-3960
Practice Address - Fax:607-973-2309
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-20
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY154518-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00897810Medicaid
NY161302632Medicaid
NY54419AMedicare PIN