Basic Information
Provider Information
NPI: 1851407720
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HEMSLEY
FirstName: MICHAEL
MiddleName: LEON
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10 CRESTMONT RD APT 6R
Address2:  
City: MONTCLAIR
State: NJ
PostalCode: 070421936
CountryCode: US
TelephoneNumber: 9737830178
FaxNumber:  
Practice Location
Address1: 300 71ST ST
Address2: SUITE 620
City: MIAMI BEACH
State: FL
PostalCode: 331413038
CountryCode: US
TelephoneNumber: 3058669951
FaxNumber: 3056143352
Other Information
ProviderEnumerationDate: 08/22/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X25MA07988100NJY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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