Miromedical P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

093763 Issued in NY

Legal business name

MIROMEDICAL P.C.

Practice address

2364 Frederick Douglass Blvd
New York, NY 10027-3640

Phone

(212) 666-3533

Fax

(212) 666-3535

NPI assigned

Aug 6, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Natalia Dochim

Title

Manager

Phone

(212) 666-3533

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281052800000",
    "number": "1003120619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2364 FREDERICK DOUGLASS BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10027",
            "telephone_number": "212-666-3533",
            "fax_number": "212-666-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2364 FREDERICK DOUGLASS BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100273640",
            "telephone_number": "212-666-3533",
            "fax_number": "212-666-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIROMEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-06",
        "last_updated": "2010-08-06",
        "status": "A",
        "authorized_official_last_name": "DOCHIM",
        "authorized_official_first_name": "NATALIA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "212-666-3533"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "093763",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "093763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keana Roya Mirmajlesi, MD
• Benjamin Daniel Mirman, MD
• Lucy A Miro-Quesada, LCSW
• Andi Miro, DDS
• Edmund Siaton Miro
• Carly D Miron, MA
• Noga Miron
• Christine McMorrow Mironenko, NP
• Svetlana Mironov, MD
• Suzanne Mirovich

• Family Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.