Provider Demographics
NPI:1750965547
Name:OKANE, MICHAEL PAUL (MA)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:PAUL
Last Name:OKANE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 BIBBINS RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06612-1344
Mailing Address - Country:US
Mailing Address - Phone:203-767-7805
Mailing Address - Fax:
Practice Address - Street 1:300 GEORGE ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-6624
Practice Address - Country:US
Practice Address - Phone:203-767-7805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-08
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program