MEDICARE: DR. MIREILLE ZARIN DSW

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
1	1041C0700X	Clinical Social Worker	PR018834	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0023492GHI	OTHER	NY	GHI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245383041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIREILLE ZARIN DSW

Provider Business Mailing Address
First Line	:	70 GLEN COVE ROAD
Second Line	:	SUITE 201
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1730
Country	:	US
Telephone Number	:	516-621-1263
Fax Number	:	516-621-1263

Provider Business Practice Location Address
First Line	:	70 GLEN COVE ROAD
Second Line	:	SUITE 201
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1730
Country	:	US
Telephone Number	:	516-621-1263
Fax Number	:	516-621-1263

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	07/08/2007

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