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General NPI Number Information
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NPI Number | 1295312346
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Entity Type | Individual
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Provider Name | ROXANA MIR MD, MPH
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Gender | Female
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Dates
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Enumeration Date | 03/25/2021
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 375 WILLARD AVE
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City | NEWINGTON
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State | CT
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Zip | 06111-2300
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Country | US
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Telephone | 860-972-2780
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Fax |
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Provider Business Mailing Address
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Address Line | 263 FARMINGTON AVE
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City | FARMINGTON
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State | CT
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Zip | 06030-1921
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Country | US
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Telephone | 860-679-2147
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Fax | 860-679-4624
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 82455
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License Number State | CT
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