# HICKSVILLE PEDIATRICS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508134578
- **Authorized official:** DR. DEEPTI MEHROTRA M. D., (PRESIDENT)
- **Authorized official phone:** (516) 719-0344

## Contact information

- **Practice address:** 535 S BROADWAY, SUITE 1, HICKSVILLE, NY 11801-5029
- **Practice address phone:** (516) 719-0344
- **Practice address fax:** (516) 719-0345
- **Mailing address:** 535 S BROADWAY, SUITE 1, HICKSVILLE, NY 11801-5029
- **Mailing address phone:** (516) 719-0344
- **Mailing address fax:** (516) 719-0345

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 211597 | NY | Yes |

## Other

- **Enumeration date:** 12/06/2011
- **Last updated:** 01/04/2012