Provider Demographics
NPI:1619026531
Name:MEHAR, GURINDER SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:GURINDER
Middle Name:SINGH
Last Name:MEHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ELM ST
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-1410
Mailing Address - Country:US
Mailing Address - Phone:845-534-7700
Mailing Address - Fax:845-534-3674
Practice Address - Street 1:14 ELM ST
Practice Address - Street 2:
Practice Address - City:CORNWALL
Practice Address - State:NY
Practice Address - Zip Code:12518-1410
Practice Address - Country:US
Practice Address - Phone:845-534-7700
Practice Address - Fax:845-534-3674
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167546207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00983106Medicaid
NYB13386Medicare UPIN
NY34E791Medicare ID - Type Unspecified