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General NPI Number Information
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NPI Number | 1659822849
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Entity Type | Individual
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Provider Name | MICHAEL V. MOTISE-PACIER N.P.
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Gender | Male
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Dates
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Enumeration Date | 10/22/2016
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Last Update Date | 02/27/2019
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Provider Practice Location Address
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Address Line | 272 YERRY HILL RD
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City | WOODSTOCK
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State | NY
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Zip | 12498
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Country | US
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Telephone | 914-426-2644
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Fax |
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Provider Business Mailing Address
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Address Line | 272 YERRY HILL RD
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City | WOODSTOCK
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State | NY
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Zip | 12498-2315
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 30-307772
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 342809
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License Number State | NY
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