Individual
PRABHU MEHTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 MONTAUK HWY, WEST ISLIP, NY 11795-4927
(631) 376-4161
Mailing address
1000 MONTAUK HWY, DEPARTMENT OF NEONATOLOGY, WEST ISLIP, NY 11795-4927
(631) 376-4161
(631) 376-3676
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
171718
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01800760
—
NY
Enumeration date
07/28/2005
Last updated
07/08/2007
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