MEDICARE: MICHAEL CORREA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	215842	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083765531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL CORREA MD

Provider Business Mailing Address
First Line	:	1302 AMSTERDAM AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-4244
Country	:	US
Telephone Number	:	212-665-8012
Fax Number	:	212-222-8905

Provider Business Practice Location Address
First Line	:	1302 AMSTERDAM AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-4281
Country	:	US
Telephone Number	:	212-665-8012
Fax Number	:	212-665-0233

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	04/25/2017

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