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General NPI Number Information
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NPI Number | 1699372565
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Entity Type | Individual
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Provider Name | MICAELA AUSTIN
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Gender | Female
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Dates
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Enumeration Date | 10/05/2020
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 760 BROADWAY
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City | BROOKLYN
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State | NY
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Zip | 11206-5383
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Country | US
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Telephone | 718-963-6091
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Fax |
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Provider Business Mailing Address
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Address Line | 10561 AVENUE N
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City | BROOKLYN
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State | NY
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Zip | 11236-4613
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Country | US
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Telephone | 917-385-9850
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 626651
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License Number State | NY
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