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General NPI Number Information
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NPI Number | 1518312859
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Entity Type | Individual
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Provider Name | MICHAEL LEONARD MARCHESE M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/24/2016
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 27005 76TH AVE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1402
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Country | US
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Telephone | 631-455-5367
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Fax |
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Provider Business Mailing Address
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Address Line | 27005 76TH AVE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1402
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Country | US
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Telephone | 631-455-5367
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 92020
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License Number State | GA
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