Provider Demographics
NPI:1578091773
Name:HIRANO, MIKA (DPM)
Entity Type:Individual
Prefix:
First Name:MIKA
Middle Name:
Last Name:HIRANO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 5TH AVE RM 506
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-7838
Mailing Address - Country:US
Mailing Address - Phone:212-921-7900
Mailing Address - Fax:212-921-7908
Practice Address - Street 1:501 5TH AVE RM 506
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-7838
Practice Address - Country:US
Practice Address - Phone:212-921-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00357300213ES0103X
NYN007106213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery