MEDICARE: MONA VIJAY MHATRE DO

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	208100000X	Physical Medicine & Rehabilitation Physician	005453	AZ

General Provider Information

NPI Number	:	1609993179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONA VIJAY MHATRE DO

Provider Business Mailing Address
First Line	:	18444 N 25TH AVE
Second Line	:	STE 310
City	:	PHOENIX
State	:	AZ
Zip	:	85023-1261
Country	:	US
Telephone Number	:	623-537-5600
Fax Number	:	866-939-2673

Provider Business Practice Location Address
First Line	:	18444 N 25TH AVE
Second Line	:	STE 210
City	:	PHOENIX
State	:	AZ
Zip	:	85023-1261
Country	:	US
Telephone Number	:	623-537-5600
Fax Number	:	866-939-2673

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

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	08/08/2025

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Directions to “ MONA VIJAY MHATRE DO” Practice Location

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