Healthcare Provider Details

I. General information

NPI: 1992202949
Provider Name (Legal Business Name): MIRIAM CHAVA TOAFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4514 16TH AVE FL 4THE
BROOKLYN NY
11204-1101
US

IV. Provider business mailing address

4514 16TH AVE FL 4THE
BROOKLYN NY
11204-1101
US

V. Phone/Fax

Practice location:
  • Phone: 718-407-7300
  • Fax:
Mailing address:
  • Phone: 718-407-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number315754
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: