Provider Demographics
NPI:1891890422
Name:MYPHYSICIAN, P.C.
Entity Type:Organization
Organization Name:MYPHYSICIAN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YAIR
Authorized Official - Middle Name:DROR
Authorized Official - Last Name:MELAMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-577-9090
Mailing Address - Street 1:5 COLISEUM AVE
Mailing Address - Street 2:SUITE 306-307
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-3206
Mailing Address - Country:US
Mailing Address - Phone:603-577-9090
Mailing Address - Fax:603-577-8976
Practice Address - Street 1:5 COLISEUM AVE
Practice Address - Street 2:SUITE 306-307
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-3206
Practice Address - Country:US
Practice Address - Phone:603-577-9090
Practice Address - Fax:603-577-8976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10367174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3131076Medicaid
NH30210978Medicare ID - Type UnspecifiedGROUP # INCL. MEDICAID
MA3131076Medicaid