Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD108968 | NY |
N | 111NI0900X | Internist | MD108968 | NY |
N | 207RH0000X | Hematologist | MD108968 | NY |
Y | 207RX0202X | Medical Oncology | MD108968 | NY |
NPI | 1295062040 |
---|---|
Provider Name | Dr. Myles Ralph Desner |
First Address | Jericho, NY 11753-1306 |
Second Address | Jericho, NY 11753-1306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2009 |
Last Update Date | 13/11/2009 |