Healthcare Provider Details

I. General information

NPI: 1699559104
Provider Name (Legal Business Name): MR. CLAUDIO L. MIRO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 DELAWARE RD
MORRISTOWN NJ
07960-5723
US

IV. Provider business mailing address

5 DELAWARE RD
MORRISTOWN NJ
07960-5723
US

V. Phone/Fax

Practice location:
  • Phone: 973-495-6686
  • Fax:
Mailing address:
  • Phone: 973-495-6686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: