Provider Demographics
NPI:1225262918
Name:MATHUR, MITHLESH (MD)
Entity Type:Individual
Prefix:
First Name:MITHLESH
Middle Name:
Last Name:MATHUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LEFRAK CITY PLAZA
Mailing Address - Street 2:15TH FLOOR, ROOM #1 DEPARTMENT OF CORRECTION, HEALTH MA
Mailing Address - City:N.Y
Mailing Address - State:NY
Mailing Address - Zip Code:11368
Mailing Address - Country:US
Mailing Address - Phone:718-595-2500
Mailing Address - Fax:718-595-2564
Practice Address - Street 1:1 LEFRAK CITY PLAZA
Practice Address - Street 2:15TH FLOOR, ROOM #1
Practice Address - City:N.Y
Practice Address - State:NY
Practice Address - Zip Code:11368
Practice Address - Country:US
Practice Address - Phone:718-595-2500
Practice Address - Fax:718-595-2564
Is Sole Proprietor?:No
Enumeration Date:2009-05-08
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145-999-1207P00000X, 207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease