Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N006172 | NY |
NPI | 1447367446 |
---|---|
Provider Name | Dr. Lyudmila Mirochnik |
First Address | Brooklyn, NY 11214 |
Second Address | Brooklyn, NY 11214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 02/08/2007 |