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General NPI Number Information
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NPI Number | 1851345102
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Entity Type | Individual
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Provider Name | ANNIE L MIRANDA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 06/11/2012
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Provider Practice Location Address
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Address Line | 1989 ROUTE 52 SUITE 3
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City | HOPEWELL JUNCTION
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State | NY
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Zip | 12533-3533
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Country | US
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Telephone | 845-897-4500
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Fax | 845-897-4550
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Provider Business Mailing Address
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Address Line | 1989 ROUTE 52 SUITE 3
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City | HOPEWELL JUNCTION
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State | NY
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Zip | 12533-3533
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Country | US
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Telephone | 845-897-4500
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Fax | 845-897-4550
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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 | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | 210185
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License Number State | NY
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