Provider Demographics
NPI:1669015483
Name:MIAN, ZOYA H
Entity Type:Individual
Prefix:DR
First Name:ZOYA
Middle Name:H
Last Name:MIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-4100
Mailing Address - Country:US
Mailing Address - Phone:800-218-5604
Mailing Address - Fax:800-218-4924
Practice Address - Street 1:619 MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-4100
Practice Address - Country:US
Practice Address - Phone:800-218-5604
Practice Address - Fax:800-218-4924
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist