Provider Demographics
NPI:1114643624
Name:MIRANDA MILAN, ARIANA NICOLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ARIANA
Middle Name:NICOLE
Last Name:MIRANDA MILAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W 140TH ST APT 5E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-7355
Mailing Address - Country:US
Mailing Address - Phone:939-218-7526
Mailing Address - Fax:
Practice Address - Street 1:600 W 140TH ST APT 5E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-7355
Practice Address - Country:US
Practice Address - Phone:939-218-7526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069710183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist