Individual
MS. ANNA MARIA MIRZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2050 TILDEN AVE, BOX 1000, NEW HARTFORD, NY 13413-3613
(315) 797-3114
(315) 624-0474
Mailing address
2050 TILDEN AVE, BOX 1000, NEW HARTFORD, NY 13413-3613
(315) 797-3114
(315) 624-0474
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
007228-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00313539
—
NY
05
—
01815443
—
NY
Enumeration date
11/15/2011
Last updated
11/15/2011
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