Provider Demographics
NPI:1750475976
Name:AFKHAMI-RAMIREZ, MIRIAM M (PHD)
Entity Type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:M
Last Name:AFKHAMI-RAMIREZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 OVERHILL LN
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1407
Mailing Address - Country:US
Mailing Address - Phone:516-627-3162
Mailing Address - Fax:516-627-3162
Practice Address - Street 1:5 OVERHILL LN
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1407
Practice Address - Country:US
Practice Address - Phone:516-627-3162
Practice Address - Fax:516-627-3162
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006186103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV1479-1Medicare ID - Type UnspecifiedPROVIDER #
NY0046435Medicare UPIN