Provider Demographics
NPI:1225021173
Name:MYRKA, ANNE M (RPH, BCPS)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:M
Last Name:MYRKA
Suffix:
Gender:F
Credentials:RPH, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 N HOOSICK RD
Mailing Address - Street 2:
Mailing Address - City:EAGLE BRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:12057-2914
Mailing Address - Country:US
Mailing Address - Phone:518-686-5245
Mailing Address - Fax:
Practice Address - Street 1:64 N HOOSICK RD
Practice Address - Street 2:
Practice Address - City:EAGLE BRIDGE
Practice Address - State:NY
Practice Address - Zip Code:12057-2914
Practice Address - Country:US
Practice Address - Phone:518-686-5245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0413831835P1200X
VT03300035181835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy