Provider Demographics
NPI:1447367446
Name:MIROCHNIK, LYUDMILA (DPM)
Entity type:Individual
Prefix:DR
First Name:LYUDMILA
Middle Name:
Last Name:MIROCHNIK
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 BAY PARKWAY
Mailing Address - Street 2:APT 1G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214
Mailing Address - Country:US
Mailing Address - Phone:718-234-0009
Mailing Address - Fax:718-234-5164
Practice Address - Street 1:7701 BAY PARKWAY
Practice Address - Street 2:APT 1G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214
Practice Address - Country:US
Practice Address - Phone:718-234-0009
Practice Address - Fax:718-234-5164
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006172213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine