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NPI Code Detail

MEDICARE: DR. MOITRI NATH DATTA M.D.

MEDICARE: DR. MOITRI NATH DATTA 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
12084P0804XChild & Adolescent Psychiatry Physician138997NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2138997OTHERNYMEDICAL LICENSE

General Provider Information

NPI Number : 1861530446
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOITRI NATH DATTA M.D.
Provider Business Mailing Address
First Line : 9 OVERHILL RD
Second Line :
City : SCARSDALE
State : NY
Zip : 10583-5307
Country : US
Telephone Number : 914-723-3247
Fax Number : 914-723-4211
Provider Business Practice Location Address
First Line : 510 N BROADWAY
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10603-3217
Country : US
Telephone Number : 914-723-3247
Fax Number : 914-723-4211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2007
Last Update Date : 03/07/2023

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