Individual
DR. ALEXANDER MIRONOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
488 GREAT NECK RD, GREAT NECK, NY 11021-4315
(516) 482-6747
Mailing address
630 W 168TH ST # 4, NEW YORK, NY 10032-3725
(212) 305-5996
(212) 305-7237
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
293403
NY
207RC0000X
Cardiovascular Disease Physician
Primary
293403
NY
Other
Enumeration date
06/13/2014
Last updated
08/29/2022
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