Mincolla, Michael
Mincolla, Michael is an sole proprietor health care provider with primary practice located at 4939 Brittonfield Pkwy , East Syracuse NY 13057-9208. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mincolla, Michael can be contacted via phone (315) 463-1600.Contact Information
Primary practice address
4939 Brittonfield Pkwy
East Syracuse NY 13057-9208
Phone: (315) 463-1600
Fax: (315) 634-6795
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 261562 | New York |
Profile Details
| NPI number | 1851546014 |
|---|---|
| LBN Legal business name | Mincolla, Michael |
| Credentials | MC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 1st, 2008 |
| Last updated | Nov 21st, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851546014 | NPPES |
| New York | MEDICAID | 03359208 |
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