Provider Demographics
NPI:1952401879
Name:MILANO, MICHAEL CONSTANTINOS (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:CONSTANTINOS
Last Name:MILANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:776 NORTHFIELD AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1102
Mailing Address - Country:US
Mailing Address - Phone:973-731-7707
Mailing Address - Fax:973-669-0277
Practice Address - Street 1:375 MOUNT PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2750
Practice Address - Country:US
Practice Address - Phone:973-731-7707
Practice Address - Fax:973-669-0277
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03634900207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MM473200Medicare ID - Type Unspecified
D06730Medicare UPIN