Individual
MS. MIRA RUCANDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14414 25TH DR, FLUSHING, NY 11354-1323
(516) 508-2423
Mailing address
14414 25TH DR, FLUSHING, NY 11354-1323
(516) 508-2423
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
38 382566
NY
Other
Enumeration date
03/15/2016
Last updated
03/15/2016
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