| Mahtab Motieian MD PC | |
|
114 Ridge Rd Ardsley NY 10502-2220 | |
| (904) 955-6577 | |
| Not Available |
| Full Name | Mahtab Motieian MD PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 114 Ridge Rd, Ardsley, New York |
| Authorized Official Name and Position | Mahtab Motieian (MD) |
| Authorized Official Contact | 9049556577 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mahtab Motieian MD PC 114 Ridge Rd Ardsley NY 10502-2220 | Mahtab Motieian MD PC 114 Ridge Rd Ardsley NY 10502-2220 Ph: (904) 955-6577 |
| NPI Number | 1598542276 |
|---|---|
| Provider Enumeration Date | 09/14/2023 |
| Last Update Date | 09/14/2023 |
| Certification Date | 09/14/2023 |
| Medicare PECOS PAC ID | 8426406778 |
|---|---|
| Medicare Enrollment ID | O20231127001728 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598542276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Sherry Yasin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285901272 PECOS PAC ID: 3072831924 Enrollment ID: I20180723000707 |
| Provider Name | Mahtab Motieian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417479692 PECOS PAC ID: 8820338601 Enrollment ID: I20201221001795 |
| Provider Name | Brenda Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851001556 PECOS PAC ID: 9931543873 Enrollment ID: I20240426002284 |
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