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General NPI Number Information
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NPI Number | 1578891826
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Entity Type | Organization
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Legal Business Name | RAY C MIRANDA MD PLLC
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Dates
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Enumeration Date | 11/25/2009
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Last Update Date | 11/25/2009
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Provider Practice Location Address
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Address Line | 14225 37TH AVE. C-3
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City | FLUSHING
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State | NY
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Zip | 11354-6531
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Country | US
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Telephone | 718-359-3777
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Fax | 718-359-3770
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Provider Business Mailing Address
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Address Line | 14225 37TH AVE. C-3
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City | FLUSHING
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State | NY
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Zip | 11354-6531
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Country | US
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Telephone | 718-359-3777
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Fax | 718-359-3770
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Authorized Official
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Title or Position | M.D.
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Name | RAY C MIRANDA
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Credential |
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Telephone | 718-359-3777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 217149
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License Number State | NY
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