Provider Demographics
NPI:1720274657
Name:ESTEPA, MYLA D (MD)
Entity Type:Individual
Prefix:DR
First Name:MYLA
Middle Name:D
Last Name:ESTEPA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1571 WASHINGTON ST
Mailing Address - Street 2:STE 107
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-9219
Mailing Address - Country:US
Mailing Address - Phone:315-782-7330
Mailing Address - Fax:315-782-5773
Practice Address - Street 1:1571 WASHINGTON ST
Practice Address - Street 2:STE 107
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-9219
Practice Address - Country:US
Practice Address - Phone:315-782-7330
Practice Address - Fax:315-782-5773
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2020-02-06
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Provider Licenses
StateLicense IDTaxonomies
NY275030-01208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics