Healthcare Provider Details

I. General information

NPI: 1164009213
Provider Name (Legal Business Name): MIHIR JANI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 WATERS PL
BRONX NY
10461-2720
US

IV. Provider business mailing address

281 1ST AVE
NEW YORK NY
10003-2925
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-7246
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number25MA13071200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number318923
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: