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Individual

ASIT MEHTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
13420 JAMAICA AVE, 1ST FLOOR AXEL BUILDING, JAMAICA, NY 11418-2619
(718) 206-6742
(718) 206-6905
Mailing address
80 MARCUS DR, PROVIDER ENROLLMENT, MELVILLE, NY 11747-4230
(631) 391-7887
(631) 454-4163

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
182648
NY
207RG0100X
Gastroenterology Physician
Primary
182648
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01410140
NY
Enumeration date
03/24/2006
Last updated
07/21/2010
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