Provider Demographics
NPI:1851706949
Name:MICHAEL, LINDSAY S (DO)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:S
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-1169
Mailing Address - Country:US
Mailing Address - Phone:607-664-4640
Mailing Address - Fax:
Practice Address - Street 1:1316 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-1169
Practice Address - Country:US
Practice Address - Phone:607-664-4640
Practice Address - Fax:607-733-4404
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301761207Q00000X
PAOS017771207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103143663Medicaid