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General NPI Number Information
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NPI Number | 1699565119
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Entity Type | Individual
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Provider Name | MINA M MICHAEL PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 3201 KINGS HWY
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City | BROOKLYN
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State | NY
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Zip | 11234-2625
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Country | US
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Telephone | 732-640-6264
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Fax |
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Provider Business Mailing Address
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Address Line | 899 EVERGREEN CT
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-2333
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Country | US
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Telephone | 732-640-6264
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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 | 1835C0205X
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Taxonomy Name | Critical Care Pharmacist
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License Number | RP456838
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1835C0205X
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Taxonomy Name | Critical Care Pharmacist
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License Number | 070432
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License Number State | NY
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