Healthcare Provider Details

I. General information

NPI: 1679543250
Provider Name (Legal Business Name): MICHAEL POKROY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 12/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 W 6TH ST 2401
RENO NV
89503-4548
US

IV. Provider business mailing address

3680 SALERNO DR
RENO NV
89509-6606
US

V. Phone/Fax

Practice location:
  • Phone: 775-770-6550
  • Fax: 775-770-6549
Mailing address:
  • Phone: 702-595-4891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number3144
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA30660
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: