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Organization
MSAN MEDICAL CARE PC
Active
Organization
MSAN MEDICAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYAT SAN M.D. (PRESIDENT)
(718) 576-3354
Entity
Organization
Contact information
Practice address
6861 FRESH POND RD, RIDGEWOOD, NY 11385-5263
(718) 576-3354
(715) 576-3505
Mailing address
6861 FRESH POND RD, RIDGEWOOD, NY 11385-5263
(718) 576-3354
(715) 576-3505
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
231830
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134284581
NATIONAL PROVIDER IDENTIFICATION
NY
Enumeration date
03/08/2018
Last updated
06/16/2018
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