Active NPI
Mya San
- Pharmacist
- Rego Park, NY
National Provider Identifier
1194057612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 053264-1
- Practice address
- 9511 63Rd Dr
Rego Park, NY 11374-2024 - Phone
- (718) 897-0803
- Fax
- (718) 897-0804
- NPI assigned
- Feb 9, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 053264-1 | NY | Primary |
Addresses
Primary practice location
9511 63Rd Dr
Rego Park, NY 11374-2024
Mailing address
9511 63Rd Dr
Rego Park, NY 11374-2024
Phone (718) 897-0803
Other names 1
- Dr. Mya San
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 053264-1 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duane Reade | Past | Accepting new patients | |
| Duane Reade | Past | Accepting new patients | |
| Duane Reade | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747094400000",
"number": "1194057612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9511 63RD DR",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113742024",
"telephone_number": "718-897-0803",
"fax_number": "718-897-0804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9511 63RD DR",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113742024",
"telephone_number": "718-897-0803",
"fax_number": "718-897-0804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAN",
"first_name": "MYA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-09",
"last_updated": "2025-05-13",
"certification_date": "2025-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "053264-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MYA",
"last_name": "SAN",
"prefix": "DR.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.