Healthcare Provider Details

I. General information

NPI: 1871027482
Provider Name (Legal Business Name): MICHAEL SCHIRRIPA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2017
Last Update Date: 08/16/2021
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 RICHMOND RD APT 7E
STATEN ISLAND NY
10304-2435
US

IV. Provider business mailing address

475 SEAVIEW AVE
STATEN ISLAND NY
10305-3436
US

V. Phone/Fax

Practice location:
  • Phone: 646-302-9027
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number308120
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: