Active NPI
Martina Michlickova
- Acupuncturist
- Port Jefferson, NY
National Provider Identifier
1568933554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 005461
- Practice address
- 301 E Main St
Port Jefferson, NY 11777-1873 - Phone
- (516) 236-6098
- NPI assigned
- Dec 17, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 005461 | NY | Primary |
Addresses
Primary practice location
301 E Main St
Port Jefferson, NY 11777-1873
Mailing address
1 Carol PL
Farmingdale, NY 11735-2805
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005461 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545004800000",
"number": "1568933554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CAROL PL",
"city": "FARMINGDALE",
"state": "NY",
"postal_code": "117352805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E MAIN ST",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "117771873",
"telephone_number": "516-236-6098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHLICKOVA",
"first_name": "MARTINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-17",
"last_updated": "2018-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "005461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.