Provider Demographics
NPI:1164017430
Name:BUHNER, MYLES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MYLES
Middle Name:
Last Name:BUHNER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 BEACH RD
Mailing Address - Street 2:
Mailing Address - City:WADING RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:11792-1307
Mailing Address - Country:US
Mailing Address - Phone:631-929-3599
Mailing Address - Fax:
Practice Address - Street 1:153 BEACH RD
Practice Address - Street 2:
Practice Address - City:WADING RIVER
Practice Address - State:NY
Practice Address - Zip Code:11792-1307
Practice Address - Country:US
Practice Address - Phone:631-929-3599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063779183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist