MEDICARE: DR. MICHAEL ALLEN GOTT M.D.

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207X00000X	Orthopaedic Surgery Physician	259503	NY

General Provider Information

NPI Number	:	1780849133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ALLEN GOTT M.D.

Provider Business Mailing Address
First Line	:	1133 WESTCHESTER AVE # N008
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10604-3516
Country	:	US
Telephone Number	:	914-358-9700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1133 WESTCHESTER AVE # N008
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10604-3516
Country	:	US
Telephone Number	:	914-358-9700
Fax Number	:

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

Provider Enumeration Date	:	07/25/2008
Last Update Date	:	12/09/2014

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