Provider Demographics
NPI:1982872909
Name:MIRSKI, DARIO FABIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DARIO
Middle Name:FABIAN
Last Name:MIRSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BONNELL LN
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-4841
Mailing Address - Country:US
Mailing Address - Phone:973-895-8813
Mailing Address - Fax:
Practice Address - Street 1:15 BONNELL LN
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-4841
Practice Address - Country:US
Practice Address - Phone:973-895-8813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD187422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry