Myla Anderson

Key facts

NPI

1124331756

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X

License

PCT.0010779 (CT)

Practice address

293 3Rd Ave
West Haven, CT 06516-5404

Phone

(203) 691-1670

NPI assigned

Jul 25, 2010

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 25, 2010.

{
    "created_epoch": "1280016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280016000000",
    "number": "1124331756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 3RD AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065165404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 3RD AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065165404",
            "telephone_number": "203-691-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MYLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-25",
        "last_updated": "2010-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CT",
            "license": "PCT.0010779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

• Joseph Anthony Amatruda, PSY.D, MPH
• Cheryl Ann Amendola, PT
• Jennifer Obrien Anastasio, PHARMD
• Jaimie L. Anderson, APRN
• Larry Allen Anderson, PA-C
• Evan Angelus, MD
• Angie'S Prestige Homecare
• Michael Christopher Anil
• Brett Alan Ankawi, PHD
• John Philip Antinone

All providers in West Haven, CT · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Connecticut