Provider Demographics
NPI:1396831764
Name:MORIN, MICHAEL P (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:MORIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:6 EXECUTIVE PARK DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3791
Practice Address - Country:US
Practice Address - Phone:518-641-6319
Practice Address - Fax:518-641-6850
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2018-01-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY177463208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY711043OtherMVP
NY72670OtherGHI/HMO
NY070123000054OtherFIDELIS
NY193AS1OtherEMPIRE BC
NY5002022OtherAETNA
NY000401053014OtherBSNENY
NY10006143OtherCDPHP
NY200094OtherSENIOR WHOLE HEALTH
NY01249834Medicaid
NY200094OtherSENIOR WHOLE HEALTH
NY5002022OtherAETNA