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Individual

MIKE MIRON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
984 N BROADWAY, STE 402, YONKERS, NY 10701-1308
(914) 378-0377
(914) 378-0372
Mailing address
40-04 KILADA COURT, FAIR LAWN, NJ 07410-5342
(201) 791-1178
(201) 791-6226

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
1706241
NY
207W00000X
Ophthalmology Physician
MA04779100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0036507
GHI
NJ
01
0036507
GHI
NY
01
00E531
EMPIRE BCBS
NY
05
01026195
NY
01
040426012288
FIDELIS CARE
NY
01
0H1451
HEALTHNET
NY
01
0K7798
HEALTHNET
NJ
01
1005794
AETNA
NY
01
1053130001
DME
NY
01
16205
AETNA
NJ
01
18003346
RAILROAD MEDICARE
NY
05
1974807
NJ
01
47791
MAGNACARE
NJ
01
HIP18102
HIP
NY
01
WS1270
OXFORD
NJ
01
WS1270
OXFORD
NY
Enumeration date
10/25/2006
Last updated
07/08/2007
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