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General NPI Number Information
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NPI Number | 1578169256
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Entity Type | Individual
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Provider Name | MARIA MICHELLE DAYAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/08/2020
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Last Update Date | 08/20/2021
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Provider Practice Location Address
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Address Line | 7801 MYRTLE AVE
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City | GLENDALE
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State | NY
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Zip | 11385-7439
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Country | US
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Telephone | 718-386-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 6812 YELLOWSTONE BLVD APT 4U
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City | FOREST HILLS
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State | NY
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Zip | 11375-3244
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Country | US
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Telephone | 646-441-7578
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 025946
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 025946
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License Number State | NY
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