Provider Demographics
NPI:1427204106
Name:AST, MICHAEL PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PAUL
Last Name:AST
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:140 E RIDGEWOOD AVE STE 175S
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3917
Mailing Address - Country:US
Mailing Address - Phone:201-599-8056
Mailing Address - Fax:201-599-8055
Practice Address - Street 1:140 E RIDGEWOOD AVE STE 175S
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-599-8056
Practice Address - Fax:201-599-8055
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY252444207X00000X, 207XS0114X
NJ25MA09267200207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05130492Medicaid
NJ25MA09267200OtherSTATE LICENSE
NY252444OtherSTATE LICENSE