Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 26NJ00984300 | NJ |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | SP021479 | PA |
NPI | 1679108559 |
---|---|
Provider Name | Mrs. Sarah Jane Miranda |
First Address | Haddon Twp, NJ 08107-1813 |
Second Address | Philadelphia, PA 19107-4216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2020 |
Last Update Date | 11/03/2020 |