Provider Demographics
NPI:1891920799
Name:MICHAEL D HEALY PHYSICIAN PC
Entity Type:Organization
Organization Name:MICHAEL D HEALY PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-666-6391
Mailing Address - Street 1:495 MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:MT. KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3031
Mailing Address - Country:US
Mailing Address - Phone:914-666-6391
Mailing Address - Fax:914-666-3825
Practice Address - Street 1:495 MAIN ST.
Practice Address - Street 2:
Practice Address - City:MT. KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3031
Practice Address - Country:US
Practice Address - Phone:914-666-6391
Practice Address - Fax:914-666-3825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-20
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145448207R00000X, 302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No302R00000XManaged Care OrganizationsHealth Maintenance OrganizationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY97A271Medicare PIN