MEDICARE: NANCY A MIKHAEL M.A.

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1831463116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY A MIKHAEL M.A.

Provider Business Mailing Address
First Line	:	242 FAHY AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-7203
Country	:	US
Telephone Number	:	347-567-7036
Fax Number	:

Provider Business Practice Location Address
First Line	:	88 NEW DORP PLZ S
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2966
Country	:	US
Telephone Number	:	917-703-5024
Fax Number	:

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

Provider Enumeration Date	:	03/03/2012
Last Update Date	:	06/05/2023

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