Individual
DR. DAVENDRA MEHTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
117-10 HILLSIDE AVENUE, RICHMOND HILL, NY 11419
(718) 297-0440
(718) 297-0442
Mailing address
1 GUSTAVE L LEVY PL, BOX 1030, NEW YORK, NY 10029-6500
(212) 241-7272
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
191259
NY
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
191259
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01424148
—
NY
Enumeration date
06/21/2006
Last updated
04/26/2019
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