Individual
VIKTORIYA MIRKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
525 E 68TH ST, NEW YORK, NY 10065-4870
(646) 525-1188
Mailing address
525 E 68TH ST, NEW YORK, NY 10065-4870
(646) 962-8456
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
018222
NY
363AS0400X
Surgical Physician Assistant
018222
NY
Other
Enumeration date
12/05/2014
Last updated
11/01/2019
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