Provider Demographics
NPI:1740650126
Name:MYLES, ANGELA (DAC)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:MYLES
Suffix:
Gender:F
Credentials:DAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 35TH ST UNIT B313
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-2236
Mailing Address - Country:US
Mailing Address - Phone:347-403-9141
Mailing Address - Fax:
Practice Address - Street 1:67 35TH ST UNIT B313
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-2236
Practice Address - Country:US
Practice Address - Phone:347-403-9141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-29
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25005146171100000X
NY005146-01171100000X
NY27 025664225700000X
NY25 005146171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1740650126OtherNONE