Individual
MIRAV LAVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
2724 MILL AVE FL 1, BROOKLYN, NY 11234-6422
(718) 415-5536
Mailing address
2724 MILL AVE FL 1, BROOKLYN, NY 11234-6422
(718) 415-5536
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
1435314201
—
252Y00000X
Early Intervention Provider Agency
Primary
1435314201
NY
Other
Enumeration date
06/08/2021
Last updated
06/09/2021
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