Provider Demographics
NPI:1992813083
Name:KAHN, MIRIAM GAIL
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:GAIL
Last Name:KAHN
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 1:200 WEST 111 ST
Mailing Address - Street 2:4G
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10026
Mailing Address - Country:US
Mailing Address - Phone:212-622-7699
Mailing Address - Fax:
Practice Address - Street 1:5 PERRYRIDGE ROAD
Practice Address - Street 2:GREENWICH HOSPITAL - OUTPATIENT DEPARTMENT
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830
Practice Address - Country:US
Practice Address - Phone:203-863-4418
Practice Address - Fax:203-863-3446
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002942363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner