MEDICARE: ENRIQUE F MEJIA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	152955	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144220047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ENRIQUE F MEJIA M.D.

Provider Business Mailing Address
First Line	:	20622 WHITEHALL TER
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11427-1721
Country	:	US
Telephone Number	:	718-843-8844
Fax Number	:	718-843-7681

Provider Business Practice Location Address
First Line	:	13110 LIBERTY AVE
Second Line	:
City	:	SOUTH RICHMOND HILL
State	:	NY
Zip	:	11419-3124
Country	:	US
Telephone Number	:	718-843-8844
Fax Number	:	718-843-7681

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	05/07/2025

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