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General NPI Number Information
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NPI Number | 1740463272
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Entity Type | Individual
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Provider Name | MORTEZA MEFTAH M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 02/24/2021
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Provider Practice Location Address
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Address Line | 1650 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10457-7606
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Country | US
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Telephone | 718-518-5814
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Fax | 718-579-3929
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Provider Business Mailing Address
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Address Line | 1650 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10457-7606
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Country | US
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Telephone | 718-518-5814
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Fax | 718-579-3929
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 272057
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License Number State | NY
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