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

Miriam Tavakoly

Individual provider Physician Assistant · NPI 1710247192

Miriam Tavakoly is a Physician Assistant in Brooklyn, New York. Qualified in 2011, 15 years ago. Practices with Corona Medical PC, a 3-clinician group and accepts Medicare assignment.

Years since qualifying
15
In the registry since
2012
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Practice location Address checks out

1664 E 14th St Ste 101
Brooklyn, NY 11229-1155
Phone: (718) 998-2350
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1710247192
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 20, 2012
Last updated in NPPESMay 20, 2012

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Corona Medical Pc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Brooklyn