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Organization

THE MIA CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KAREN CONSTANCE FIELD PNP (OWNER)
(631) 996-4430
Entity
Organization

Contact information

Practice address
12 PLATINUM CT STE C, MEDFORD, NY 11763-2247
(631) 996-4430
Mailing address
12 PLATINUM CT STE C, MEDFORD, NY 11763-2247
(631) 996-4430

Taxonomy

Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1497902506
NY
Enumeration date
09/09/2021
Last updated
09/09/2021
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