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General NPI Number Information
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NPI Number | 1265399711
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Entity Type | Individual
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Provider Name | JOSEVITO MIRANDA RN
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Gender | Male
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 53 GLEN KEITH RD APT U
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City | GLEN COVE
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State | NY
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Zip | 11542-3588
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Country | US
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Telephone | 631-664-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 53 GLEN KEITH RD APT U
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City | GLEN COVE
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State | NY
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Zip | 11542-3588
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN2265566
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 978973
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License Number State | NY
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