MEDICARE: DR. STEPHANIE LYNN MIRAGLIA DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	006357	NY

General Provider Information

NPI Number	:	1295053080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE LYNN MIRAGLIA DPM

Provider Business Mailing Address
First Line	:	7512 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228-2410
Country	:	US
Telephone Number	:	718-680-0575
Fax Number	:

Provider Business Practice Location Address
First Line	:	7512 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228-2410
Country	:	US
Telephone Number	:	718-680-0575
Fax Number	:

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

Provider Enumeration Date	:	05/04/2010
Last Update Date	:	05/04/2010

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