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1164108130
JOHN MIRASOL
NEW YORK, NY
NPI
1164108130
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163WC0200X Registered Nurse, Critical Care Medicine
(Licence: NY 679048)
Enumeration Date
2023-06-26
Last Update Date
2023-06-26
Business Address
JOHN MIRASOL
560 WEST 168TH STREET
NEW YORK, NY 10032
Phone number: 212-305-4318
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Mailing Address
JOHN MIRASOL
15 AVALON COURT
STATEN ISLAND, NY 10303
Phone number:
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