Basic Information
| Provider Information | |||||||||
| NPI: | 1003013046 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MICALE | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | N. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5000 BOARDWALK | ||||||||
| Address2: | APT. 914 | ||||||||
| City: | VENTNOR CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 084062915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2016868248 | ||||||||
| FaxNumber: | 2016620672 | ||||||||
| Practice Location | |||||||||
| Address1: | 5000 BOARDWALK | ||||||||
| Address2: | APT. 914 | ||||||||
| City: | VENTNOR CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 084062915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2016620623 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2007 | ||||||||
| LastUpdateDate: | 11/04/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 25MA01971100 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.