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NPI Code Detail

MEDICARE: DR. ELIZABETH MIRO D.D.S.

MEDICARE: DR. ELIZABETH MIRO D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry052320NY

General Provider Information

NPI Number : 1205983814
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELIZABETH MIRO D.D.S.
Provider Business Mailing Address
First Line : 282 WYNDCLIFFE RD
Second Line :
City : SCARSDALE
State : NY
Zip : 10583-4833
Country : US
Telephone Number : 914-722-0382
Fax Number :
Provider Business Practice Location Address
First Line : 3535 HILL BLVD
Second Line : SUITE O
City : YORKTOWN HEIGHTS
State : NY
Zip : 10598-1293
Country : US
Telephone Number : 914-245-7272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 07/08/2007

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