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General NPI Number Information
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NPI Number | 1942681200
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Entity Type | Individual
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Provider Name | KIRAN MIAN D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/12/2015
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 12 W 21ST ST FL 6
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City | NEW YORK
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State | NY
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Zip | 10010-6914
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Country | US
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Telephone | 212-343-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 483 10 AVENUE SUITE 310
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City | NEW YORK
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State | NY
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Zip | 10018
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Country | US
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Telephone | 917-970-9100
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Fax | 917-970-9200
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 714
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License Number State | IL
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