Individual
DR. JOSEPH MIRAKHOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
43 BELLINGHAM LN, GREAT NECK, NY 11023-1322
(516) 482-1866
Mailing address
43 BELLINGHAM LN, GREAT NECK, NY 11023-1322
(516) 482-1866
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
248599
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00669
MEDICARE GROUP
NY
01
—
00825838
MEDICAID GROUP
NY
05
—
03044713
—
NY
Enumeration date
05/28/2008
Last updated
07/17/2009
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