| Organization Name: | MIRKIN VISION CARE PC |
| NPI Number: | 1417920042 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANIEL S MIRKIN (PRESIDENT) |
| Mailing Address: | 253 Beach 116th St Rockaway Park |
| State: | NY US |
| Postal Code: | 116942102 |
| Phone Number: | 7186340005 |
| Fax Number: | 7184742003 |
| NPI Enumeration Date: | 02/13/2006 |
| NPI Last Update Date: | 03/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | VUT004688 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |