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General NPI Number Information
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NPI Number | 1356425128
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Entity Type | Individual
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Provider Name | MIKE MIRON MD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 984 N BROADWAY STE 402
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City | YONKERS
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State | NY
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Zip | 10701-1308
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Country | US
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Telephone | 914-378-0377
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Fax | 914-378-0372
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Provider Business Mailing Address
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Address Line | 40-04 KILADA COURT
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City | FAIR LAWN
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State | NJ
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Zip | 07410-5342
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Country | US
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Telephone | 201-791-1178
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Fax | 201-791-6226
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 1706241
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MA04779100
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License Number State | NJ
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