Healthcare Provider Details

I. General information

NPI: 1013206457
Provider Name (Legal Business Name): AMRUT HEMATOLOGY ONCOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2011
Last Update Date: 04/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250-12B HILLSIDE AVE
BELLROSE NY
11426
US

IV. Provider business mailing address

PO BOX 7409
HICKSVILLE NY
11802-7409
US

V. Phone/Fax

Practice location:
  • Phone: 888-785-3430
  • Fax:
Mailing address:
  • Phone: 516-547-1674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number252587
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License Number252587
License Number StateNY

VIII. Authorized Official

Name: DR. ANSHU MEHRISHI
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 516-547-1674