Individual
MIRELA LISA LIPAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1034 166TH ST APT 4D, WHITESTONE, NY 11357-2242
(718) 801-6906
Mailing address
1034 166TH ST APT 4D, WHITESTONE, NY 11357-2242
(718) 801-6906
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
654235
NY
363L00000X
Nurse Practitioner
Primary
343508
NY
Other
Enumeration date
05/28/2014
Last updated
10/01/2018
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