Provider Demographics
NPI:1942465174
Name:MEYLER, STANISLAV (PA)
Entity Type:Individual
Prefix:MR
First Name:STANISLAV
Middle Name:
Last Name:MEYLER
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:3567 SHORE PKWY
Mailing Address - Street 2:FL 2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2668
Mailing Address - Country:US
Mailing Address - Phone:718-648-8877
Mailing Address - Fax:718-648-4647
Practice Address - Street 1:3567 SHORE PKWY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2668
Practice Address - Country:US
Practice Address - Phone:718-648-8877
Practice Address - Fax:718-648-4647
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2016-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY012569363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant