Individual
NATASHA MIRZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 CIVIC CENTER BLVD, SOUTH PAVILION, 3RD FLOOR, PHILADELPHIA, PA 19104-5127
(215) 662-2777
(215) 662-4613
Mailing address
3400 CIVIC CENTER BLVD, SOUTH PAVILION, 3RD FLOOR, PHILADELPHIA, PA 19104-5127
(215) 662-2777
(215) 662-4613
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD050143L
PA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
MD050143L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015553970002
—
PA
Enumeration date
06/30/2006
Last updated
03/11/2026
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