| Deepak S. Mahajan Physician P.c | |
|
8675 Midland Pkwy Suite 2 Jamaica NY 11432-3058 | |
| (718) 523-2177 | |
| (718) 523-2133 |
| Full Name | Deepak S. Mahajan Physician P.c |
|---|---|
| Speciality | Internal Medicine |
| Location | 8675 Midland Pkwy, Jamaica, New York |
| Authorized Official Name and Position | Sucheta D Mahajan (ATTENDING) |
| Authorized Official Contact | 5166274577 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deepak S. Mahajan Physician P.c 38 Lake Dr New Hyde Park NY 11040-1123 Ph: (516) 627-4577 | Deepak S. Mahajan Physician P.c 8675 Midland Pkwy Suite 2 Jamaica NY 11432-3058 Ph: (718) 523-2177 |
| NPI Number | 1376567925 |
|---|---|
| Provider Enumeration Date | 07/27/2006 |
| Last Update Date | 12/17/2015 |
| Medicare PECOS PAC ID | 6002810140 |
|---|---|
| Medicare Enrollment ID | O20090724000174 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376567925 | NPI | - | NPPES |
| 02752674 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 238466 (New York) | Primary |
| Provider Name | Deepak S Mahajan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295700375 PECOS PAC ID: 8921020710 Enrollment ID: I20051221000291 |
| Provider Name | Sucheta D Mahajan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770584427 PECOS PAC ID: 0941304505 Enrollment ID: I20070409000513 |
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