Haim Misholy, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

141725 Issued in NY

Practice address

4616 Nesconset Hwy
Port Jefferson Station, NY 11776-2563

Phone

(631) 473-7070

Fax

(631) 331-2654

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Haim Misholy Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1194877985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4616 NESCONSET HWY",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762563",
            "telephone_number": "631-473-7070",
            "fax_number": "631-331-2654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4616 NESCONSET HWY",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762563",
            "telephone_number": "631-473-7070",
            "fax_number": "631-331-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHOLY",
        "first_name": "HAIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "141725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "A400036609",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "141725",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAIM",
            "last_name": "MISHOLY",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Zara Clare Miller, OT
• Amy Elizabeth Millheiser, LCSW
• Melena Leigh Mills, RPH
• Mary Anne Miranda, NP-C
• Usman Mirza, MD, MBA
• Lorene Margaret Mistretta, R.N.
• Eric Ira Mitchnick, MD
• Jacquelyn Mitra
• Antoun Saba Mitromaras, M.D.
• Leanne Mary Molia, M.D.

• Specialist in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.