Provider Demographics
NPI:1326043290
Name:BOXER, MYRON CHARLES (DPM)
Entity Type:Individual
Prefix:DR
First Name:MYRON
Middle Name:CHARLES
Last Name:BOXER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2 WOODMERE BLVD S
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1729
Mailing Address - Country:US
Mailing Address - Phone:516-374-2033
Mailing Address - Fax:516-295-6862
Practice Address - Street 1:2 WOODMERE BLVD S
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1729
Practice Address - Country:US
Practice Address - Phone:516-374-2033
Practice Address - Fax:516-295-6862
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002065-1213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPO2065-2BOtherWORKERS' COMPENSATION
NYYP19261OtherCHAMPUS
NYASO12OtherOXFORD HEALTH PLANS
NY03386OtherMEDICARE GHI
NY0017708OtherGROUP HEALTH INSURANCE
NY00401170Medicaid
NYASO12OtherOXFORD HEALTH PLANS
NYT50668Medicare UPIN