Miracle City, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MIRACLE CITY, LLC

Practice address

2800 Bruckner Blvd Ste 205
Bronx, NY 10465-1972

Phone

(914) 222-4156

Fax

(320) 205-4576

NPI assigned

Feb 3, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Andrea Corson, LCSW-R

Title

Chief Compliance Officer

Phone

(914) 222-4156

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556064000000",
    "number": "1790223394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 BRUCKNER BLVD STE 205",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104651972",
            "telephone_number": "914-222-4156",
            "fax_number": "320-205-4576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 BRUCKNER BLVD STE 205",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104651972",
            "telephone_number": "914-222-4156",
            "fax_number": "320-205-4576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE CITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-03",
        "last_updated": "2019-04-24",
        "status": "A",
        "authorized_official_last_name": "CORSON",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "914-222-4156",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadeem Mir, P.A.
• Charlene Mirabal
• Nemesis Mirabal, RD
• Farhad Mirabrishami
• Nancy Mirach, SOCIAL WORKER
• Zashary Scarpellie Miranda Soto
• Julissa Miranda Valdez
• Yeismel Miranda-Valdes, PHARM.D.
• Andres Miranda, DDS
• Carolina Miranda, MD

• Community/Behavioral Health Agency in Bronx, NY
• Providers in Bronx, NY by specialty
• Community/Behavioral Health Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.