MEDICARE: MR. DAGNERY MURIEL

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	174400000X	Specialist	797714	NY

General Provider Information

NPI Number	:	1841552932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAGNERY MURIEL

Provider Business Mailing Address
First Line	:	3548 71ST ST
Second Line	:	1 FLOOR
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-3941
Country	:	US
Telephone Number	:	718-607-8442
Fax Number	:

Provider Business Practice Location Address
First Line	:	3548 71ST ST
Second Line	:	1 FLOOR
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-3941
Country	:	US
Telephone Number	:	718-607-8442
Fax Number	:

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

Provider Enumeration Date	:	06/13/2012
Last Update Date	:	06/13/2012

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Directions to “ MR. DAGNERY MURIEL ” Practice Location

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