Miranda, Luis Da Graca

Miranda, Luis Da Graca is an sole proprietor health care provider with primary practice located at 11 Ralph Place Suite 202, Staten Island NY 10304. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Miranda, Luis Da Graca can be contacted via phone (718) 448-1555.

Contact Information

Primary practice address
11 Ralph Place Suite 202 Staten Island NY 10304
Phone: (718) 448-1555
Fax: (718) 448-3950
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 115278 New York

Profile Details

NPI number 1548239213
LBN Legal business name Miranda, Luis Da Graca
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 15th, 2006
Last updated Oct 5th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548239213 NPPES
New York MEDICAID 00251487

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