MEDICARE: ANDREW RYAN MAHABIR

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	207P00000X	Emergency Medicine Physician	MT236458	PA

General Provider Information

NPI Number	:	1629914361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW RYAN MAHABIR

Provider Business Mailing Address
First Line	:	3032 HEWLETT AVE
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-5313
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2545 SCHOENERSVILLE RD
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18017-7300
Country	:	US
Telephone Number	:	610-402-8000
Fax Number	:

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

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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