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1942492897
MARY ANNE MIRANDA
PORT JEFFERSON STATION, NY
NPI
1942492897
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: NY F304650)
Enumeration Date
2007-08-14
Last Update Date
2014-01-13
Business Address
-- MARY ANNE MIRANDA NP-C
931 HALLOCK AVE
PORT JEFFERSON STATION, NY 11776-1228
Phone number: 631-331-7200
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Mailing Address
-- MARY ANNE MIRANDA NP-C
7 ELM ST
CENTRAL ISLIP, NY 11722-4111
Phone number: 631-232-1572
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