Mirza, Justin Bruno

Mirza, Justin Bruno is an sole proprietor health care provider with primary practice located at 51-15 Beach Channel Drive Peninsula Hospital Center, Far Rockaway NY 11691. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Mirza, Justin Bruno can be contacted via phone (718) 734-3020.

Contact Information

Primary practice address
51-15 Beach Channel Drive Peninsula Hospital Center Far Rockaway NY 11691
Phone: (718) 734-3020
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 258198 New York

Profile Details

NPI number 1356648570
LBN Legal business name Mirza, Justin Bruno
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 24th, 2011
Last updated Feb 24th, 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 1356648570 NPPES
New York MEDICAID 258198

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