Provider Demographics
NPI:1497170674
Name:MIEROV, BEVERLY (SPECIAL EDUCATOR)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:
Last Name:MIEROV
Suffix:
Gender:F
Credentials:SPECIAL EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7563 113TH ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5551
Mailing Address - Country:US
Mailing Address - Phone:646-400-3111
Mailing Address - Fax:
Practice Address - Street 1:7563 113TH ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5551
Practice Address - Country:US
Practice Address - Phone:646-400-3111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency