Healthcare Provider Details

I. General information

NPI: 1992797187
Provider Name (Legal Business Name): ANDREW P MEZEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 57TH ST
BROOKLYN NY
11219-4636
US

IV. Provider business mailing address

21 AGNES CIR
ARDSLEY NY
10502-1706
US

V. Phone/Fax

Practice location:
  • Phone: 718-283-3650
  • Fax: 718-283-3602
Mailing address:
  • Phone: 914-693-5670
  • Fax: 914-693-6436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number087128
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: