| Doctor Name: | MICHAEL J EVANS |
| NPI Number: | 1104871284 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | 000533-1 |
| Business Practice Address: | 255 Lafayette Ave Good Samaritan Hospital Suffern, NY - 109014812 |
| Business Phone Number: | 8453688800 |
| Business Fax Number: | 8453685608 |
| Mailing Address: | 255 Lafayette Ave, Good Samaritan Hospital SUFFERN |
| State: | NY |
| Postal Code: | 109014812 |
| Phone Number: | 8453688800 |
| Fax Number: | 8453685608 |
| NPI Enumeration Date: | 05/24/2006 |
| NPI Last Update Date: | 03/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 000533-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |