Provider Demographics
NPI:1992966519
Name:MIRABELLI, MAE MAE ANDREA YU-SHIH (MD)
Entity type:Individual
Prefix:DR
First Name:MAE MAE
Middle Name:ANDREA YU-SHIH
Last Name:MIRABELLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:61 ZURKO FARM RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-3064
Mailing Address - Country:US
Mailing Address - Phone:917-554-9579
Mailing Address - Fax:
Practice Address - Street 1:61 ZURKO FARM RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06461-3064
Practice Address - Country:US
Practice Address - Phone:917-554-9579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2377912085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology