Healthcare Provider Details

I. General information

NPI: 1477384477
Provider Name (Legal Business Name): DR. MIKA GEVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 E 20TH ST APT 4C
NEW YORK NY
10010-7617
US

IV. Provider business mailing address

541 E 20TH ST APT 4C
NEW YORK NY
10010-7617
US

V. Phone/Fax

Practice location:
  • Phone: 646-713-6015
  • Fax:
Mailing address:
  • Phone: 646-713-6015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberP129197
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: