Individual
MATTHEW MEKHAIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-9564
(212) 342-3591
Mailing address
630 W 168TH ST # 4, NEW YORK, NY 10032-3725
(212) 305-9564
(212) 342-3591
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
309404
NY
363LG0600X
Gerontology Nurse Practitioner
309404
NY
Other
Enumeration date
01/31/2020
Last updated
05/14/2020
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