MARCO K MICHELSON, MD, PC
Osteopathic Medicine at Port Washington Blvd, Port Washington, NY

License number
New York 188110
Category
Osteopathic Medicine
Type
Infectious Disease
Owner
Name: MARCO K MICHELSON MD
Title: PRESIDENT
Phone: (917) 771-2111
Address
Address
1051 Port Washington Blvd, Port Washington, NY 11050
National Provider ID: 1700048832
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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MARCO K. MICHELSON, M.D., PC

PO Box 766, Port Washington, NY 11050

Status:
Inactive
Inactive reason:
Dissolution by Proclamation / Annulment of Authority
Registration:
Oct 27, 2000
Inactive since:
Jul 29, 2009
State ID:
2568167
Business type:
Domestic Professional Corporation
Md Marco K. Michelson, PO Box 766, Port Washington, NY 11050 (Physical)

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