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Organization
PRIYA MOHANTY MEDICAL PRACTICE PLLC
Active
Organization
PRIYA MOHANTY MEDICAL PRACTICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRIYA D. MOHANTY M.D. (PRESIDENT)
(716) 238-1782
Entity
Organization
Contact information
Practice address
2626 W STATE ST, STE # 208, OLEAN, NY 14760-1858
(716) 790-8038
(716) 790-8041
Mailing address
2626 W STATE ST, STE # 208, OLEAN, NY 14760-1858
(716) 790-8038
(716) 790-8041
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
224111
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02319928
—
NY
05
—
1021088750001
—
PA
01
—
1194712695
INDIVIDUAL NPI
—
Enumeration date
09/14/2010
Last updated
07/16/2013
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