1225262918 NPI number — MITHLESH MATHUR MD

Table of content: MITHLESH MATHUR MD (NPI 1225262918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225262918 NPI number — MITHLESH MATHUR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MATHUR
Provider First Name:
MITHLESH
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225262918
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/08/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 LEFRAK CITY PLAZA
Provider Second Line Business Mailing Address:
15TH FLOOR, ROOM #1 DEPARTMENT OF CORRECTION, HEALTH MA
Provider Business Mailing Address City Name:
N.Y
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11368
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-595-2500
Provider Business Mailing Address Fax Number:
718-595-2564

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 LEFRAK CITY PLAZA
Provider Second Line Business Practice Location Address:
15TH FLOOR, ROOM #1
Provider Business Practice Location Address City Name:
N.Y
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11368
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-595-2500
Provider Business Practice Location Address Fax Number:
718-595-2564
Provider Enumeration Date:
05/08/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  145-999-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 145-999-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RC0000X , with the licence number: 145-999-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com