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NPI Code Detail

MEDICARE: LUISA MEJIA

MEDICARE:   LUISA  MEJIA
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
12085U0001XDiagnostic Ultrasound Physician00068290NY

General Provider Information

NPI Number : 1578170528
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUISA MEJIA
Provider Business Mailing Address
First Line : 851 E 216TH ST
Second Line :
City : BRONX
State : NY
Zip : 10467-5816
Country : US
Telephone Number : 845-636-6594
Fax Number :
Provider Business Practice Location Address
First Line : 130 W KINGSBRIDGE RD
Second Line :
City : BRONX
State : NY
Zip : 10468-3904
Country : US
Telephone Number : 718-584-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2020
Last Update Date : 09/24/2020

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Directions to “ LUISA MEJIA ” Practice Location

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