Individual
MR. MICHAEL RICHARD MIRABELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC, CSCS
Contact information
Practice address
550 NORTH ST, DEPARTMENT OF ATHLETICS, WHITE PLAINS, NY 10605-3004
(914) 422-2000
Mailing address
88 TODD HILL RD, POUGHKEEPSIE, NY 12603-3923
(845) 473-4169
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000860
NY
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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