=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215468087
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MICHAEL B. CROSS, MD, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2017
-----------------------------------------------------
Last Update Date | 03/23/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 523 E 72ND ST ATTENTION: MICHAEL CROSS, M.D.
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10021-4099
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-774-2114
-----------------------------------------------------
Fax | 646-797-8298
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 535 E 70TH ST ATTENTION: MICHAEL CROSS, M.D.
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10021-4823
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-774-2114
-----------------------------------------------------
Fax | 646-797-8298
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | MICHAEL B CROSS
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 212-774-2114
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------