| Mesbah Medical Pc | |
|
10 Walnut Dr Roslyn NY 11576-2333 | |
| (310) 922-2446 | |
| (718) 526-7438 |
| Full Name | Mesbah Medical Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10 Walnut Dr, Roslyn, New York |
| Authorized Official Name and Position | Reza Mesbah (PRESIDENT) |
| Authorized Official Contact | 3109222446 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mesbah Medical Pc 10 Walnut Dr Roslyn NY 11576-2333 Ph: (310) 922-2446 | Mesbah Medical Pc 10 Walnut Dr Roslyn NY 11576-2333 Ph: (310) 922-2446 |
| NPI Number | 1174962641 |
|---|---|
| Provider Enumeration Date | 06/18/2013 |
| Last Update Date | 01/24/2024 |
| Medicare PECOS PAC ID | 7618111923 |
|---|---|
| Medicare Enrollment ID | O20130926000013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174962641 | NPI | - | NPPES |
| 03375697 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 261697 (New York) | Primary |
| Provider Name | Reza Mesbah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235465089 PECOS PAC ID: 0840461877 Enrollment ID: I20110922000288 |
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