Healthcare Provider Details

I. General information

NPI: 1205523032
Provider Name (Legal Business Name): MICHEL ACHKAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2023
Last Update Date: 03/12/2024
Certification Date: 04/21/2023
Deactivation Date: 11/24/2023
Reactivation Date: 03/12/2024

III. Provider practice location address

475 SEAVIEW AVENUE
STATEN ISLAND NY
10305
US

IV. Provider business mailing address

CHEHAHARA STREET MANOUR RICHANI BUILDING
QLEIAAT QLEIAAT
02303
LB

V. Phone/Fax

Practice location:
  • Phone: 718-226-8313
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: