Provider Demographics
NPI:1740256908
Name:NAARENDORP, MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:NAARENDORP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:301 W 118TH ST
Mailing Address - Street 2:APT PH-3F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-1049
Mailing Address - Country:US
Mailing Address - Phone:212-360-5752
Mailing Address - Fax:212-280-0603
Practice Address - Street 1:51 SAINT NICHOLAS AVE
Practice Address - Street 2:APT PH-3F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-3467
Practice Address - Country:US
Practice Address - Phone:212-360-5752
Practice Address - Fax:212-280-0603
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2017-03-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY229836207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01921948Medicaid
NY01921948Medicaid
NY80V631Medicare ID - Type Unspecified