MEDICARE: MOHAWK VALLEY MULTISPECIALTY MEDICAL GROUP PLLC

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	2084N0400X	Neurology Physician

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	:	1184616930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOHAWK VALLEY MULTISPECIALTY MEDICAL GROUP PLLC

Provider Business Mailing Address
First Line	:	PO BOX 11719
Second Line	:	MOHAWK VALLEY MULTISPECIALTY MEDICAL GROUP PLLC
City	:	ALBANY
State	:	NY
Zip	:	12211-0719
Country	:	US
Telephone Number	:	185-389-1725
Fax Number	:

Provider Business Practice Location Address
First Line	:	4988 STATE HIGHWAY 30
Second Line	:	AMSTERDAM MEMORIAL SUITE 201
City	:	AMSTERDAM
State	:	NY
Zip	:	12010-7520
Country	:	US
Telephone Number	:	518-428-5119
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMSHAID A MINHAS
Credential	:	MD
Telephone Number	:	518-389-1725

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	04/08/2020

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