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General NPI Number Information
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NPI Number | 1124251012
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Entity Type | Organization
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Legal Business Name | G. S. MEHAR PHYSICIAN, P.C.
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 11/10/2009
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Provider Practice Location Address
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Address Line | 14 ELM ST
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City | CORNWALL
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State | NY
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Zip | 12518-1410
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Country | US
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Telephone | 845-534-7700
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Fax | 845-534-3674
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Provider Business Mailing Address
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Address Line | 14 ELM ST
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City | CORNWALL
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State | NY
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Zip | 12518-1410
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Country | US
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Telephone | 845-534-7700
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Fax | 845-534-3674
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Authorized Official
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Title or Position | OWNER
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Name | DR. GURINDER S MEHAR
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Credential | M.D.
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Telephone | 845-534-7700
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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 | 167456
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License Number State | NY
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