Provider Demographics
NPI:1467652636
Name:CERVONE, MICHELLE ANN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ANN
Last Name:CERVONE
Suffix:
Gender:
Credentials:MD
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Mailing Address - Street 1:113 UNIVERSITY PL FL 11
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4527
Mailing Address - Country:US
Mailing Address - Phone:212-484-2356
Mailing Address - Fax:646-486-6495
Practice Address - Street 1:113 UNIVERSITY PL FL 11
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4527
Practice Address - Country:US
Practice Address - Phone:212-484-2356
Practice Address - Fax:646-486-6495
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2007562084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry