Provider Demographics
NPI:1619028818
Name:NEIMAN, MYLES SAMUEL (OD)
Entity Type:Individual
Prefix:DR
First Name:MYLES
Middle Name:SAMUEL
Last Name:NEIMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:514 BECKMAN DR
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-7411
Mailing Address - Country:US
Mailing Address - Phone:412-751-2027
Mailing Address - Fax:
Practice Address - Street 1:1616 MALL RUN RD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-2640
Practice Address - Country:US
Practice Address - Phone:724-439-5250
Practice Address - Fax:724-439-8876
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001781152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT72912Medicare UPIN