Provider Demographics
NPI:1194860601
Name:MIRTO, JOSEPH R (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:MIRTO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-7313
Mailing Address - Country:US
Mailing Address - Phone:212-838-6600
Mailing Address - Fax:212-980-8578
Practice Address - Street 1:580 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-7313
Practice Address - Country:US
Practice Address - Phone:212-838-6600
Practice Address - Fax:212-980-8578
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0024421111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition