Individual
MRS. CARMEN MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
937 FERNDALE BLVD, CENTRAL ISLIP, NY 11722-4230
(631) 926-2570
Mailing address
937 FERNDALE BLVD, CENTRAL ISLIP, NY 11722-4230
(631) 926-2570
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
310307-1
NY
Other
Enumeration date
02/13/2013
Last updated
02/13/2013
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