Individual
DR. USMAN MIRZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MBA
Contact information
Practice address
815 HALLOCK AVE STE A, PORT JEFFERSON STATION, NY 11776-1244
(631) 828-3036
Mailing address
815 HALLOCK AVE STE A, PORT JEFFERSON STATION, NY 11776-1244
(631) 828-3036
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
306390
NY
2084N0400X
Neurology Physician
Primary
306390
NY
Other
Enumeration date
07/12/2017
Last updated
04/26/2024
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