Healthcare Provider Details

I. General information

NPI: 1881899243
Provider Name (Legal Business Name): MIRANDA S TELEGRAFI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3299 CAMBRIDGE AVE
BRONX NY
10463-3623
US

IV. Provider business mailing address

2116 HIMROD ST
RIDGEWOOD NY
11385-1235
US

V. Phone/Fax

Practice location:
  • Phone: 718-884-6342
  • Fax:
Mailing address:
  • Phone: 718-417-5674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number511634-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number511634-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: