Organization
MIRACLE CHILREN INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORNA HOSANG MS. ED. (DIRECTOR)
(347) 858-6537
Entity
Organization
Contact information
Practice address
18908 MANGIN AVE, SAINT ALBANS, NY 11412-2320
(347) 858-6537
Mailing address
18908 MANGIN AVE, SAINT ALBANS, NY 11412-2320
(347) 858-6537
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
174847021
NY
302F00000X
Exclusive Provider Organization
174847021
NY
Other
Enumeration date
06/08/2012
Last updated
06/08/2012
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