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General NPI Number Information
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NPI Number | 1760452528
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Entity Type | Individual
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Provider Name | RICHARD A MICHAELSON MD
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Gender | Male
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 06/10/2013
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Provider Practice Location Address
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Address Line | 94 OLD SHORT HILLS RD
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5672
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Country | US
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Telephone | 973-322-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 25 FELLSWOOD DR
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City | ESSEX FELLS
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State | NJ
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Zip | 07021-1805
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Country | US
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Telephone | 973-403-0181
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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 | 25MA03881400
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License Number State | NJ
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