Mirkin, Daniel Scott

Mirkin, Daniel Scott is an sole proprietor health care provider with primary practice located at 253 Beach 116Th St , Rockaway Park NY 11694-2102. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Mirkin, Daniel Scott can be contacted via phone (718) 634-0005.

Contact Information

Primary practice address
253 Beach 116Th St Rockaway Park NY 11694-2102
Phone: (718) 634-0005
Fax: (718) 474-2003
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X VUT004688 New York
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X VUT004688 New York
Eye and Vision Services Providers / Pediatrics 152WP0200X VUT004688 New York

Profile Details

NPI number 1558363630
LBN Legal business name Mirkin, Daniel Scott
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 2nd, 2005
Last updated Oct 25th, 2011 - about 13 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 1558363630 NPPES
Other OP90652 AETNA
Other 1558363630 AETNA
Other G400012756 AETNA
Other P824790 AETNA
MEDICAID 01126778 AETNA
Other DM0C408810 AETNA

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