Provider Demographics
NPI:1891886933
Name:MICHAEL NEKORANIK DO PC
Entity Type:Organization
Organization Name:MICHAEL NEKORANIK DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:NEKORANIK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:908-213-3433
Mailing Address - Street 1:224-228 ROSEBERRY ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1687
Mailing Address - Country:US
Mailing Address - Phone:908-213-3433
Mailing Address - Fax:908-213-3647
Practice Address - Street 1:224-228 ROSEBERRY ST
Practice Address - Street 2:SUITE 5
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1687
Practice Address - Country:US
Practice Address - Phone:908-213-3433
Practice Address - Fax:908-213-3647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA123197Medicare PIN
NJ122641Medicare PIN