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General NPI Number Information
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NPI Number | 1508145301
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Entity Type | Organization
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Legal Business Name | MICHAEL CILIP JR
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 3300 CHAMBERS RD SUITE 5238
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City | HORSEHEADS
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State | NY
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Zip | 14845-1404
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Country | US
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Telephone | 607-846-3960
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Fax | 607-739-1276
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Provider Business Mailing Address
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Address Line | 3300 CHAMBERS RD SUITE 5238
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City | HORSEHEADS
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State | NY
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Zip | 14845-1404
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Country | US
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Telephone | 607-846-3960
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Fax | 607-739-1276
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL CILIP
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Credential | MD
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Telephone | 607-846-3960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 154518-1
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License Number State | NY
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