Healthcare Provider Details

I. General information

NPI: 1790703965
Provider Name (Legal Business Name): BRIAN M MEHLING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 STATE ST STE 101
HACKENSACK NJ
07601-5521
US

IV. Provider business mailing address

214 STATE ST STE 101
HACKENSACK NJ
07601-5521
US

V. Phone/Fax

Practice location:
  • Phone: 201-342-7662
  • Fax: 201-342-7662
Mailing address:
  • Phone: 201-342-7662
  • Fax: 201-342-7662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number219517-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MA07210900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: