Healthcare Provider Details

I. General information

NPI: 1225628258
Provider Name (Legal Business Name): MICHAEL VINCENT MAY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2021
Last Update Date: 02/09/2021
Certification Date: 01/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BURROWES RD
STATE COLLEGE PA
16802
US

IV. Provider business mailing address

58 BROOK DR S
MORRISTOWN NJ
07960-6614
US

V. Phone/Fax

Practice location:
  • Phone: 973-722-9629
  • Fax:
Mailing address:
  • Phone: 973-722-9629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: