Provider Demographics
NPI:1467065417
Name:DORISCAR, MIRLAINE P
Entity Type:Individual
Prefix:
First Name:MIRLAINE
Middle Name:P
Last Name:DORISCAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1587 E 52ND ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3823
Mailing Address - Country:US
Mailing Address - Phone:347-893-6710
Mailing Address - Fax:
Practice Address - Street 1:1626 PUTNEY RD
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-1818
Practice Address - Country:US
Practice Address - Phone:718-618-5075
Practice Address - Fax:929-900-1522
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker