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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851546014 NPPES
New York MEDICAID 03359208

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