Provider Demographics
NPI:1598445991
Name:MEJIAS, SETH (FNP)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:MEJIAS
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 31ST ST # 1125
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-1140
Mailing Address - Country:US
Mailing Address - Phone:315-783-7411
Mailing Address - Fax:
Practice Address - Street 1:4601 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-1117
Practice Address - Country:US
Practice Address - Phone:718-680-8881
Practice Address - Fax:718-680-7880
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF352526-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty