Healthcare Provider Details

I. General information

NPI: 1275807364
Provider Name (Legal Business Name): MICHAEL JOSEPH LOUIE MD, MPH, MSC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2012
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2519 36TH AVE
ASTORIA NY
11106-3209
US

IV. Provider business mailing address

2519 36TH AVE
ASTORIA NY
11106-3209
US

V. Phone/Fax

Practice location:
  • Phone: 914-281-0540
  • Fax: 646-594-1337
Mailing address:
  • Phone: 914-281-0540
  • Fax: 646-594-1337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number208589
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: