Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N002065-1 | NY |
NPI | 1326043290 |
---|---|
Provider Name | Dr. Myron Charles Boxer |
First Address | Woodmere, NY 11598-1729 |
Second Address | Woodmere, NY 11598-1729 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 20/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0017708 | GROUP HEALTH INSURANCE (01) | NY |
00401170 | (05) | NY |
03386 | MEDICARE GHI (01) | NY |
ASO12 | OXFORD HEALTH PLANS (01) | NY |
PO2065-2B | WORKERS' COMPENSATION (01) | NY |
T50668 | (02) | NY |
YP19261 | CHAMPUS (01) | NY |