| Doctor Name: | MICHELLE STEWART |
| NPI Number: | 1003225194 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 017815 |
| Business Practice Address: | 600 Northern Blvd Suite 300 Great Neck, NY - 110215206 |
| Business Phone Number: | 5166278717 |
| Business Fax Number: | |
| Mailing Address: | 1456 31st Dr, Apt 4h ASTORIA |
| State: | NY |
| Postal Code: | 111064569 |
| Phone Number: | 6318979922 |
| Fax Number: | |
| NPI Enumeration Date: | 08/04/2014 |
| NPI Last Update Date: | 08/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 017815 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |