RUSSELL MIRAVITE

QUEENS VILLAGE, NY
NPI1336610286
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy163WP0809X Registered Nurse, Psych/Mental Health, Adult
(Licence: NY  752463)
Enumeration Date2018-12-17
Last Update Date2018-12-17
Business Address
RUSSELL MIRAVITE RN
7925 WINCHESTER BLVD
QUEENS VILLAGE, NY 11427-2128
Phone number: 718-264-5619
Mailing Address
RUSSELL MIRAVITE RN
7734 170TH ST
FRESH MEADOWS, NY 11366-1346
Phone number: 646-384-3273