Provider Demographics
NPI:1689872749
Name:GERMAIN, MICHELE (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:GERMAIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:DAMOUR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:55 WATER ST
Mailing Address - Street 2:2ND FLOOR CRED DEPT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10041-0004
Mailing Address - Country:US
Mailing Address - Phone:646-680-2888
Mailing Address - Fax:516-542-5556
Practice Address - Street 1:9610 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-6625
Practice Address - Country:US
Practice Address - Phone:718-459-0400
Practice Address - Fax:718-670-6479
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237517207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02897616Medicaid
NY9255XNOtherMEDICARE ID