MEDICARE: CRISTINA MICELI D.O.

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	207V00000X	Obstetrics & Gynecology Physician	25MB11199200	NJ

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	:	1811420110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA MICELI D.O.

Provider Business Mailing Address
First Line	:	609 WASHINGTON ST FL 2
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-4907
Country	:	US
Telephone Number	:	201-659-7700
Fax Number	:

Provider Business Practice Location Address
First Line	:	609 WASHINGTON ST FL 2
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-4907
Country	:	US
Telephone Number	:	201-659-7700
Fax Number	:

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

Provider Enumeration Date	:	04/04/2017
Last Update Date	:	01/08/2024

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Directions to “ CRISTINA MICELI D.O.” Practice Location

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