MEDICARE: DR. MILIND MONDKAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZC0500X	Cytopathology Physician	138159	NY

General Provider Information

NPI Number	:	1679774640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MILIND MONDKAR MD

Provider Business Mailing Address
First Line	:	1085 WESTMINSTER AVE
Second Line	:
City	:	DIX HILLS
State	:	NY
Zip	:	11746-6340
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1085 WESTMINSTER AVE
Second Line	:
City	:	DIX HILLS
State	:	NY
Zip	:	11746-6340
Country	:	US
Telephone Number	:	151-699-1535
Fax Number	:	631-667-0674

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	07/08/2007

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