| Mehta Medical Pc | |
|
3979 Laconia Ave Bronx NY 10466-4916 | |
| (347) 442-7656 | |
| (347) 442-7049 |
| Full Name | Mehta Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3979 Laconia Ave, Bronx, New York |
| Authorized Official Name and Position | Neeta Mehta (OWNER) |
| Authorized Official Contact | 7189099378 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mehta Medical Pc 9 De Chiaro Ln Williston Park NY 11596-1007 Ph: (347) 442-7656 | Mehta Medical Pc 3979 Laconia Ave Bronx NY 10466-4916 Ph: (347) 442-7656 |
| NPI Number | 1861977316 |
|---|---|
| Provider Enumeration Date | 10/01/2018 |
| Last Update Date | 08/14/2020 |
| Medicare PECOS PAC ID | 5092059196 |
|---|---|
| Medicare Enrollment ID | O20181130000066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861977316 | NPI | - | NPPES |
| 182250048 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Neeta Mehta |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578820379 PECOS PAC ID: 1254626591 Enrollment ID: I20181130000246 |
| Provider Name | Sharad Kothari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245462621 PECOS PAC ID: 3577713429 Enrollment ID: I20190211003063 |
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