Healthcare Provider Details

I. General information

NPI: 1609421122
Provider Name (Legal Business Name): MULCHANDANI MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2019
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 CENTRE ST LBBY SUITE102
NEW YORK NY
10013-4552
US

IV. Provider business mailing address

P.O. BOX 541609
FLUSHING NY
11354-1609
US

V. Phone/Fax

Practice location:
  • Phone: 212-226-6866
  • Fax:
Mailing address:
  • Phone: 212-226-6866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NEIL MULCHANDANI
Title or Position: SOLE OWNER
Credential: MD
Phone: 212-226-6966