Organization
HICKSVILLE PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEEPTI MEHROTRA M. D., (PRESIDENT)
(516) 719-0344
Entity
Organization
Contact information
Practice address
535 S BROADWAY, SUITE 1, HICKSVILLE, NY 11801-5029
(516) 719-0344
(516) 719-0345
Mailing address
535 S BROADWAY, SUITE 1, HICKSVILLE, NY 11801-5029
(516) 719-0344
(516) 719-0345
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
211597
NY
Other
Enumeration date
12/06/2011
Last updated
01/04/2012
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