Provider Demographics
NPI:1447996442
Name:MIRAKOV COHEN, ESTER (CRANIAL PROSTHESIS)
Entity type:Individual
Prefix:
First Name:ESTER
Middle Name:
Last Name:MIRAKOV COHEN
Suffix:
Gender:F
Credentials:CRANIAL PROSTHESIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6509 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-1203
Mailing Address - Country:US
Mailing Address - Phone:480-793-0017
Mailing Address - Fax:
Practice Address - Street 1:6509 N 7TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-1203
Practice Address - Country:US
Practice Address - Phone:480-793-0017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-11
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier