Individual
MIRIAM TZIPORA RACKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
728 N MAIN ST, NEW SQUARE, NY 10977-8916
(845) 354-9300
Mailing address
7 SCOTFORD ST, SPRING VALLEY, NY 10977-1423
(773) 877-0582
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
421323
NY
Other
Enumeration date
03/05/2018
Last updated
10/23/2019
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