Marciano I Miclat Jr., M.D.

Primary specialty

Surgery of the Hand (Plastic Surgery) PhysicianTaxonomy code 2082S0105X

License

125470 Issued in NY

Practice address

1 Winding Brook Dr
Larchmont, NY 10538-1018

Phone

(914) 636-8657

Fax

(914) 636-8427

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740376151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WINDING BROOK DR",
            "city": "LARCHMONT",
            "state": "NY",
            "postal_code": "105381018",
            "telephone_number": "914-636-8657",
            "fax_number": "914-636-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WINDING BROOK DR",
            "city": "LARCHMONT",
            "state": "NY",
            "postal_code": "105381018",
            "telephone_number": "914-636-8657",
            "fax_number": "914-636-8427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICLAT",
        "first_name": "MARCIANO",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "NY",
            "license": "125470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery of the Hand (Plastic Surgery) Physician in Larchmont, NY
• Providers in Larchmont, NY by specialty
• Surgery of the Hand (Plastic Surgery) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.