Provider Demographics
NPI:1689685075
Name:NANGIA, MUKESH (MD)
Entity Type:Individual
Prefix:DR
First Name:MUKESH
Middle Name:
Last Name:NANGIA
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 1:81 BEACHRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1385
Mailing Address - Country:US
Mailing Address - Phone:716-636-5228
Mailing Address - Fax:
Practice Address - Street 1:81 BEACHRIDGE DR
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1385
Practice Address - Country:US
Practice Address - Phone:716-636-5228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-24513207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine