Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mariam M Kirvalidze, DO

Individual provider Family Medicine Physician · NPI 1508353517

Mariam M Kirvalidze, DO is a Family Practice in East Setauket, New York. Graduated from New York College of Osteo Medicine of New York Institute of Technology in 2018, 8 years ago. Practices with Stony Brook Family and Preventive Medicine, University Faculty Practic, a 43-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
8
Trained at
New York College of Osteo Medicine of New York Institute of Technology
Licensed in
NY
In the registry since
2018
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

181 N Belle Mead Rd Ste 2
East Setauket, NY 11733-3495
Phone: (631) 444-5858
Fax: (631) 444-1899
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 310737 (NY)

Record details

NPI number1508353517
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 16, 2018
Last updated in NPPESSeptember 25, 2022
Certification dateJuly 12, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolNEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduated 2018 (8 years in practice)
Group practice Stony Brook Family And Preventive Medicine, University Faculty Practic — 43 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in East Setauket