Provider Demographics
NPI:1063484715
Name:MYERS, BYRON A (MD)
Entity Type:Individual
Prefix:
First Name:BYRON
Middle Name:A
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 31218
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06150-1218
Mailing Address - Country:US
Mailing Address - Phone:914-328-4500
Mailing Address - Fax:845-565-6057
Practice Address - Street 1:97 AMITY ST
Practice Address - Street 2:3RD FLOOR, SUITE H-300
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-6004
Practice Address - Country:US
Practice Address - Phone:718-780-1384
Practice Address - Fax:718-780-4987
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY230552207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02498539Medicaid
NY02498539Medicaid
NYI07149Medicare UPIN