Mikyle Shakira Byrd-Vaughn, ND
Individual provider Active NPI Naturopath · Bloomfield, NJ
NPI 1508097122 · NPPES record last updated Jul 30, 2009
Key facts
- NPI
- 1508097122
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Naturopath 175F00000X
- License
- 00306 (CT)
- Practice address
- 399 Hoover Ave
Suite 9
Bloomfield, NJ 07003-3924 - Phone
- (973) 429-7878
- Fax
- (973) 429-7887
- NPI assigned
- Jul 30, 2009
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 00306 | CT | MD | Naturopath |
| 0990000175 | VT | MD | Naturopath |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 00306 | CT | Yes |
| Naturopath | 175F00000X | 0990000175 | VT |
Addresses
Primary practice location
399 Hoover Ave
Suite 9
Bloomfield, NJ 07003-3924
Mailing address
399 Hoover Ave
Suite 9
Bloomfield, NJ 07003-3924
Phone (973) 429-7878
Other providers in Bloomfield, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.