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Individual
SUSAN CHRISTY MIRABAL
Active
Individual
SUSAN CHRISTY MIRABAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D90749
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13-3971298
—
NY
Enumeration date
04/26/2018
Last updated
07/07/2021
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