Healthcare Provider Details

I. General information

NPI: 1720437163
Provider Name (Legal Business Name): OREN MICHAELI D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 SYLVAN AVE
ENGLEWOOD 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: 212-540-4263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number25MB11579300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: