Provider Demographics
NPI:1447618210
Name:PAHL, MYRIAH C (DPT)
Entity Type:Individual
Prefix:DR
First Name:MYRIAH
Middle Name:C
Last Name:PAHL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 HAMILTON PL APT 2
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-3475
Mailing Address - Country:US
Mailing Address - Phone:914-200-1475
Mailing Address - Fax:
Practice Address - Street 1:55 S BROADWAY STE 2
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-4004
Practice Address - Country:US
Practice Address - Phone:914-200-1475
Practice Address - Fax:904-490-9036
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035202225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist