Provider Information for 1265157911
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MARIAN MIKHAIL
Sex: Female
NPI: 1265157911
Last Updated: 2024-07-16
Certification Date: 2024-07-16
Certification Date: 2024-07-16
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1265157911 | ||||||||||||
| Enumeration Date | 2022-10-05 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 500 TODT HILL RD STATEN ISLAND, NY 10304-1326 United States Phone: 330-550-0258 | Fax: | ||||||||||||
| Primary Practice Address | 500 TODT HILL RD STATEN ISLAND, NY 10304-1326 United States Phone: 330-550-0258 | Fax: | ||||||||||||
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