Healthcare Provider Details

I. General information

NPI: 1184074064
Provider Name (Legal Business Name): MARTA MICHALIK D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2016
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 NOTT ST
SCHENECTADY NY
12308-2431
US

IV. Provider business mailing address

1265 HEMPSTEAD RD
NISKAYUNA NY
12309-1251
US

V. Phone/Fax

Practice location:
  • Phone: 518-374-4118
  • Fax:
Mailing address:
  • Phone: 516-343-6319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number059210
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: