MEDICARE: HADI MINHAS 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	207RG0100X	Gastroenterology Physician	297174	NY
2	207R00000X	Internal Medicine Physician	297174	NY

General Provider Information

NPI Number	:	1366898553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HADI MINHAS M.D.

Provider Business Mailing Address
First Line	:	434 S KINGSBORO AVE
Second Line	:
City	:	JOHNSTOWN
State	:	NY
Zip	:	12095-3822
Country	:	US
Telephone Number	:	518-752-5275
Fax Number	:

Provider Business Practice Location Address
First Line	:	434 S KINGSBORO AVE
Second Line	:
City	:	JOHNSTOWN
State	:	NY
Zip	:	12095-3822
Country	:	US
Telephone Number	:	518-752-5275
Fax Number	:

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

Provider Enumeration Date	:	05/06/2016
Last Update Date	:	09/19/2024

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