MEDICARE: MICHAEL C MILANO MD LLC

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	207VG0400X	Gynecology Physician	25MA03634900	NJ

General Provider Information

NPI Number	:	1265603567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL C MILANO MD LLC

Provider Business Mailing Address
First Line	:	825 BLOOMFIELD AVE
Second Line	:
City	:	VERONA
State	:	NJ
Zip	:	07044-1366
Country	:	US
Telephone Number	:	973-239-5010
Fax Number	:	973-669-0277

Provider Business Practice Location Address
First Line	:	825 BLOOMFIELD AVE
Second Line	:
City	:	VERONA
State	:	NJ
Zip	:	07044-1366
Country	:	US
Telephone Number	:	973-239-5010
Fax Number	:	973-669-0277

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. ALICE M RUIZ
Credential	:
Telephone Number	:	973-731-7707

Provider Enumeration Date	:	03/14/2008
Last Update Date	:	03/14/2008

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