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NPI Code Detail

MEDICARE: PAULA C MIRALDI I

MEDICARE:   PAULA C MIRALDI I
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistNY

General Provider Information

NPI Number : 1538833082
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULA C MIRALDI I
Provider Business Mailing Address
First Line : 2165 FEUEREISEN AVE
Second Line :
City : RONKONKOMA
State : NY
Zip : 11779-6305
Country : US
Telephone Number : 631-704-9005
Fax Number :
Provider Business Practice Location Address
First Line : 624 HAWKINS AVE
Second Line :
City : LAKE RONKONKOMA
State : NY
Zip : 11779-2375
Country : US
Telephone Number : 631-240-3579
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2021
Last Update Date : 08/06/2021

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Directions to “ PAULA C MIRALDI I ” Practice Location

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