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NPI Code Detail

MEDICARE: OCTAVIAN CONSTANTIN MIHAI P.A.

MEDICARE: OCTAVIAN CONSTANTIN MIHAI P.A.
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
1363A00000XPhysician Assistant019603-01NY

General Provider Information

NPI Number : 1649626078
Entity Type Code : Individual
Provider Name (Legal Business Name) : OCTAVIAN CONSTANTIN MIHAI P.A.
Provider Business Mailing Address
First Line : 820 SAINT ANNS AVE
Second Line :
City : BRONX
State : NY
Zip : 10456-7885
Country : US
Telephone Number : 844-400-1975
Fax Number :
Provider Business Practice Location Address
First Line : 820 SAINT ANNS AVE
Second Line :
City : BRONX
State : NY
Zip : 10456-7885
Country : US
Telephone Number : 844-400-1975
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2016
Last Update Date : 01/22/2026

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