Provider Demographics
NPI:1821262965
Name:HILTON MIRELS MD
Entity Type:Organization
Organization Name:HILTON MIRELS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HILTON
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRELS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-761-8287
Mailing Address - Street 1:175 MEMORIAL HWY
Mailing Address - Street 2:SUITE 1-15
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5635
Mailing Address - Country:US
Mailing Address - Phone:914-632-2251
Mailing Address - Fax:
Practice Address - Street 1:175 MEMORIAL HWY
Practice Address - Street 2:SUITE 1-15
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5635
Practice Address - Country:US
Practice Address - Phone:914-632-2251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179417174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01142290Medicaid
NY01142290Medicaid
NY26F631Medicare PIN