Individual
MIRELLE THALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
212 E 106TH ST, NEW YORK, NY 10029-4007
(212) 360-2600
(718) 652-6692
Mailing address
212 E 106TH ST, NEW YORK, NY 10029-4007
(212) 360-2600
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
322003-01
NY
Other
Enumeration date
03/27/2020
Last updated
09/06/2023
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