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General NPI Number Information
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NPI Number | 1992966519
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Entity Type | Individual
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Provider Name | MAE MAE ANDREA YU-SHIH MIRABELLI MD
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Gender | Female
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 05/07/2013
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Provider Practice Location Address
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Address Line | 61 ZURKO FARM RD
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City | MILFORD
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State | CT
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Zip | 06461-3064
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Country | US
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Telephone | 917-554-9579
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Fax |
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Provider Business Mailing Address
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Address Line | 61 ZURKO FARM RD
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City | MILFORD
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State | CT
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Zip | 06461-3064
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Country | US
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Telephone | 917-554-9579
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 237791
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License Number State | NY
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