Individual
ETHEL MIRIAM IUSIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
95-55 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372
(718) 478-7272
(718) 478-6455
Mailing address
95-55 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372
(718) 478-7272
(718) 478-6455
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
191660
NY
Other
Enumeration date
07/22/2009
Last updated
07/28/2009
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