Provider Demographics
NPI:1689142705
Name:MYERS, ESMINE ANN
Entity Type:Individual
Prefix:
First Name:ESMINE
Middle Name:ANN
Last Name:MYERS
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 1:16844 127TH AVE APT 8E
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3102
Mailing Address - Country:US
Mailing Address - Phone:212-920-0753
Mailing Address - Fax:
Practice Address - Street 1:16844 127TH AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-3150
Practice Address - Country:US
Practice Address - Phone:212-920-0753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral