Basic Information
| Provider Information | |||||||||
| NPI: | 1982682563 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RADIN | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1300 FRANKLIN AVE | ||||||||
| Address2: | SUITE ML-6 | ||||||||
| City: | GARDEN CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115301886 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166633511 | ||||||||
| FaxNumber: | 5166634780 | ||||||||
| Practice Location | |||||||||
| Address1: | 1300 FRANKLIN AVE | ||||||||
| Address2: | SUITE ML-6 | ||||||||
| City: | GARDEN CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115301886 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166633511 | ||||||||
| FaxNumber: | 5166634780 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2006 | ||||||||
| LastUpdateDate: | 11/11/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | 256359 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.