Provider Demographics
NPI:1780355271
Name:MICHAEL AST MD PC
Entity type:Organization
Organization Name:MICHAEL AST MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:AST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-599-8056
Mailing Address - Street 1:15 E MIDLAND AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2926
Mailing Address - Country:US
Mailing Address - Phone:201-599-8056
Mailing Address - Fax:201-599-8055
Practice Address - Street 1:15 E MIDLAND AVE STE 1A
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2926
Practice Address - Country:US
Practice Address - Phone:201-599-8056
Practice Address - Fax:201-599-8055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty