Individual provider Active NPI

Daniel Peter Mirro, M.D.

  • Psychiatry Physician
  • Marlton, NJ
National Provider Identifier
1780707281
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA02486000 Issued in NJ
Practice address
999 Route 73 N
Suite 200
Marlton, NJ 08053-1227
Phone
(856) 802-6888
Fax
(856) 802-6878
NPI assigned
Apr 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA02486000 NJ Primary

Addresses

Primary practice location

999 Route 73 N
Suite 200
Marlton, NJ 08053-1227

Mailing address

999 Route 73 N
Suite 200
Marlton, NJ 08053-1227
Phone (856) 802-6888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Mar 16, 2016 through Mar 16, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA02486000NJMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1780707281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 ROUTE 73 N",
            "address_2": "SUITE 200",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531227",
            "telephone_number": "856-802-6888",
            "fax_number": "856-802-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 ROUTE 73 N",
            "address_2": "SUITE 200",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531227",
            "telephone_number": "856-802-6888",
            "fax_number": "856-802-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRRO",
        "first_name": "DANIEL",
        "middle_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA02486000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.