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General NPI Number Information
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NPI Number | 1053371005
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Entity Type | Individual
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Provider Name | ASIT MEHTA MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 07/21/2010
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Provider Practice Location Address
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Address Line | 13420 JAMAICA AVE 1ST FLOOR AXEL BUILDING
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City | JAMAICA
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State | NY
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Zip | 11418-2619
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Country | US
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Telephone | 718-206-6742
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Fax | 718-206-6905
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Provider Business Mailing Address
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Address Line | 80 MARCUS DR PROVIDER ENROLLMENT
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City | MELVILLE
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State | NY
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Zip | 11747-4230
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Country | US
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Telephone | 631-391-7887
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Fax | 631-454-4163
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 182648
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 182648
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License Number State | NY
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