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General NPI Number Information
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NPI Number | 1891890422
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Entity Type | Organization
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Legal Business Name | MYPHYSICIAN, P.C.
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5 COLISEUM AVE SUITE 306-307
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City | NASHUA
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State | NH
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Zip | 03063-3206
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Country | US
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Telephone | 603-577-9090
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Fax | 603-577-8976
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Provider Business Mailing Address
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Address Line | 5 COLISEUM AVE SUITE 306-307
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City | NASHUA
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State | NH
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Zip | 03063-3206
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Country | US
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Telephone | 603-577-9090
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Fax | 603-577-8976
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YAIR DROR MELAMED
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Credential | M.D.
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Telephone | 603-577-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 10367
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License Number State | NH
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