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

Mr. Michael Roger Lace, PA

Individual provider Physician Assistant · NPI 1578693040

Mr. Michael Roger Lace, PA is a Physician Assistant in Bronx, New York. Licensed in New York. Registered with an NPI since 2007.

Licensed in
NY
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

111 E 210th St
Bronx, NY 10467-2401
Phone: (718) 920-5795
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 009906 (NY)

Record details

NPI number1578693040
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 6, 2007
Last updated in NPPESJuly 8, 2007

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