Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Michael Formato, MSOTR/L

Individual provider Specialist · NPI 1710258454

Mr. Michael Formato, MSOTR/L is a Specialist in Massapequa, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2012
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Practice location Address checks out

101 Paget Ln
Massapequa, NY 11758-3752
Phone: (516) 541-1664
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 0141391 (NY)

Record details

NPI number1710258454
Entity typeIndividual (Type 1)
GenderMale
Credentials MSOTR/L
Sole proprietorYes
NPI enumeratedJanuary 25, 2012
Last updated in NPPESJanuary 25, 2012

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