Provider Demographics
NPI:1245383041
Name:ZARIN, MIREILLE (DSW)
Entity Type:Individual
Prefix:DR
First Name:MIREILLE
Middle Name:
Last Name:ZARIN
Suffix:
Gender:F
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 GLEN COVE ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1730
Mailing Address - Country:US
Mailing Address - Phone:516-621-1263
Mailing Address - Fax:516-621-1263
Practice Address - Street 1:70 GLEN COVE ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1730
Practice Address - Country:US
Practice Address - Phone:516-621-1263
Practice Address - Fax:516-621-1263
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0188341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0023492GHIOtherGHI
NY01594985Medicaid
NY01594985Medicaid
R47396Medicare UPIN