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1710247192
MIRIAM TAVAKOLY
BROOKLYN, NY
NPI
1710247192
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2012-05-20
Last Update Date
2012-05-20
Business Address
-- MIRIAM TAVAKOLY
1664 E 14TH ST SUITE 101
BROOKLYN, NY 11229-1155
Phone number: 718-998-2350
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Mailing Address
-- MIRIAM TAVAKOLY
PO BOX 650067
FRESH MEADOWS, NY 11365-0067
Phone number: 917-605-7453
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