Provider Demographics
NPI:1467159863
Name:MEDICAL HEALTHCARE PROVIDER SERVICES PLLC
Entity Type:Organization
Organization Name:MEDICAL HEALTHCARE PROVIDER SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAYAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:DAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-359-4420
Mailing Address - Street 1:5014 16TH AVE STE 13
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-1404
Mailing Address - Country:US
Mailing Address - Phone:914-359-4420
Mailing Address - Fax:914-355-3035
Practice Address - Street 1:1703 47TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-1228
Practice Address - Country:US
Practice Address - Phone:914-359-4420
Practice Address - Fax:914-355-3035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty