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NPI Code Detail

MEDICARE: DR. GARY S MIRONE DO

MEDICARE: DR. GARY S MIRONE DO
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
1207VF0040XUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician25MB08050800NJ
2207V00000XObstetrics & Gynecology Physician25MB08050800NJ

General Provider Information

NPI Number : 1972653939
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY S MIRONE DO
Provider Business Mailing Address
First Line : 1 FEDERAL ST STE 200
Second Line :
City : CAMDEN
State : NJ
Zip : 08103-1088
Country : US
Telephone Number : 848-288-6935
Fax Number : 732-790-0107
Provider Business Practice Location Address
First Line : 223 N MAIN ST STE 103
Second Line :
City : CAPE MAY COURT HOUSE
State : NJ
Zip : 08210-2121
Country : US
Telephone Number : 609-463-1488
Fax Number : 609-463-4881
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2007
Last Update Date : 04/10/2025

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