MEDICARE: MICHAEL NAKAO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	130302	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538169404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL NAKAO MD

Provider Business Mailing Address
First Line	:	PO BOX 14890
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12212-4890
Country	:	US
Telephone Number	:	518-525-5634
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 PALISADES DR
Second Line	:	STE 100
City	:	ALBANY
State	:	NY
Zip	:	12205-6433
Country	:	US
Telephone Number	:	518-438-4496
Fax Number	:	518-438-5803

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	05/19/2021

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