Organization
MIRIMUS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PREM PREMSRIRUT (FOUNDER & CEO)
(929) 377-3744
Entity
Organization
Contact information
Practice address
760 PARKSIDE AVE STE 206, BROOKLYN, NY 11226-1785
(929) 377-3744
Mailing address
760 PARKSIDE AVE STE 206, BROOKLYN, NY 11226-1785
(929) 377-3744
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33D2185028
CLIA
NY
Enumeration date
11/04/2021
Last updated
11/04/2021
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