Healthcare Provider Details

I. General information

NPI: 1235006644
Provider Name (Legal Business Name): PERIPHERAL NERVE SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 SYLVAN AVE FL 2
ENGLEWOOD CLIFFS NJ
07632-3132
US

IV. Provider business mailing address

377 VALLEY RD STE 82698
CLIFTON NJ
07013-1319
US

V. Phone/Fax

Practice location:
  • Phone: 212-540-4263
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: OREN MICHAELI
Title or Position: PRESIDENT
Credential: DO
Phone: 917-993-3353