Provider Demographics
NPI:1194485847
Name:MICHAEL POLITI DO PC
Entity type:Organization
Organization Name:MICHAEL POLITI DO PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:POLITI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-241-8201
Mailing Address - Street 1:14 GLEN COVE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1732
Mailing Address - Country:US
Mailing Address - Phone:516-241-8201
Mailing Address - Fax:
Practice Address - Street 1:14 GLEN COVE RD STE 3
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1732
Practice Address - Country:US
Practice Address - Phone:516-241-8201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-22
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty