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NPI Code Detail

MEDICARE: DR. MYA SAN

MEDICARE: DR. MYA SAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist053264-1NY

General Provider Information

NPI Number : 1194057612
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MYA SAN
Provider Business Mailing Address
First Line : 9511 63RD DR
Second Line :
City : REGO PARK
State : NY
Zip : 11374-2024
Country : US
Telephone Number : 718-897-0803
Fax Number : 718-897-0804
Provider Business Practice Location Address
First Line : 9511 63RD DR
Second Line :
City : REGO PARK
State : NY
Zip : 11374-2024
Country : US
Telephone Number : 718-897-0803
Fax Number : 718-897-0804
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2010
Last Update Date : 05/13/2025

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Directions to “ DR. MYA SAN ” Practice Location

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