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General NPI Number Information
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NPI Number | 1104211572
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Entity Type | Individual
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Provider Name | MICHAEL HADLEY MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 04/02/2015
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 1190 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10029-6503
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Country | US
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Telephone | 212-427-1540
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Fax | 212-410-7196
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Provider Business Mailing Address
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Address Line | 115 E 91ST ST
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City | NEW YORK
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State | NY
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Zip | 10128-1601
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 316519
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License Number State | NY
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