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Individual

DR. MYRA MALMED NATHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
950 NEW LOUDON RD, SUITE 245, LATHAM, NY 12110-2100
(518) 785-7360
(518) 785-7360
Mailing address
950 NEW LOUDON RD, SUITE 245, LATHAM, NY 12110-2100
(518) 785-7360
(518) 785-7360

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
10227-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01667803
NY
01
137498
VALUE OPTIONS
NY
Enumeration date
01/04/2007
Last updated
07/14/2010
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