Basic Information
| Provider Information | |||||||||
| NPI: | 1902267677 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SMIGELSKI | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | BRIAN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 81 FLEET PL APT 11M | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112018017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2628947398 | ||||||||
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| Practice Location | |||||||||
| Address1: | 222 E 41ST ST FL 12 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100176739 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6468256300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2016 | ||||||||
| LastUpdateDate: | 07/11/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 315086 | NY | Y | Allopathic & Osteopathic Physicians | Urology |
No ID Information.