Provider Demographics
NPI:1861673923
Name:NORTON, MICHAEL NEVILLE
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:NEVILLE
Last Name:NORTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-2109
Mailing Address - Country:US
Mailing Address - Phone:516-742-0833
Mailing Address - Fax:516-742-6303
Practice Address - Street 1:444 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-2109
Practice Address - Country:US
Practice Address - Phone:516-742-0833
Practice Address - Fax:516-742-6303
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33480183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01020891Medicaid