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Individual

SADIE MIRABAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O

Contact information

Practice address
741 BROADWAY, NEWARK, NJ 07104-4309
(973) 675-1900
(973) 676-1396
Mailing address
741 BROADWAY, NEWARK, NJ 07104-4309
(973) 675-1900
(973) 676-1396

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MB09839200
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0532398
NJ
Enumeration date
03/30/2013
Last updated
06/16/2018
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