Provider Demographics
NPI:1427077395
Name:MYERS, JOYCE ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:ELIZABETH
Last Name:MYERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:JOYCE
Other - Middle Name:ELIZABETH
Other - Last Name:VLOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:165 DARTMOUTH ST.
Mailing Address - Street 2:HARVARD VANGUARD MEDICAL ASSOCIATES
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-5123
Mailing Address - Country:US
Mailing Address - Phone:617-859-5170
Mailing Address - Fax:617-859-5050
Practice Address - Street 1:165 DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-5123
Practice Address - Country:US
Practice Address - Phone:617-859-5170
Practice Address - Fax:617-859-5050
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA760232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE65842Medicare UPIN