Healthcare Provider Details

I. General information

NPI: 1902994825
Provider Name (Legal Business Name): MICHAEL GHALCHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

873 BROADWAY
NEW YORK NY
10003-1231
US

IV. Provider business mailing address

PO BOX 1575
NEW YORK NY
10159-1575
US

V. Phone/Fax

Practice location:
  • Phone: 212-686-0066
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number236127
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: