MEDICARE: DR. MICHAEL LAWRENCE KOLIN D.C.

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	111N00000X	Chiropractor	X009639-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	P1946771	OTHER	OXFORD HEALTH PLANS
2	613941	OTHER	UNITED HEALTHCARE
3	7654667	OTHER	AETNA US HEALTHCARE

General Provider Information

NPI Number	:	1114089430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL LAWRENCE KOLIN D.C.

Provider Business Mailing Address
First Line	:	18 FROST POND DR
Second Line	:
City	:	ROSLYN
State	:	NY
Zip	:	11576-2808
Country	:	US
Telephone Number	:	917-533-3083
Fax Number	:	212-768-1223

Provider Business Practice Location Address
First Line	:	512 FASHION AVE
Second Line	:	SUITE 1404-A
City	:	NEW YORK
State	:	NY
Zip	:	10018-4603
Country	:	US
Telephone Number	:	212-768-7979
Fax Number	:	212-768-1223

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

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	07/08/2007

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