Healthcare Provider Details

I. General information

NPI: 1144322819
Provider Name (Legal Business Name): MICHAEL G CIOROIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 03/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 10 30TH AVENUE
LIC NY
11102-2448
US

IV. Provider business mailing address

247 3RD AVE SUITE L-3
NEW YORK NY
10010-7457
US

V. Phone/Fax

Practice location:
  • Phone: 718-932-1000
  • Fax: 718-808-7297
Mailing address:
  • Phone: 212-995-8099
  • Fax: 212-995-0956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number156696
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: