Provider Demographics
NPI:1619057247
Name:MEARS, JOHN GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GREGORY
Last Name:MEARS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1978 CROMPOND RD STE G1
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-4116
Mailing Address - Country:US
Mailing Address - Phone:914-293-8400
Mailing Address - Fax:914-293-8423
Practice Address - Street 1:1978 CROMPOND RD STE G1
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4116
Practice Address - Country:US
Practice Address - Phone:914-293-8400
Practice Address - Fax:914-293-8423
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY123762207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB18882Medicare UPIN
NY71A281Medicare ID - Type Unspecified