Provider Demographics
NPI:1790703965
Name:MEHLING, BRIAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:M
Last Name:MEHLING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4919
Mailing Address - Country:US
Mailing Address - Phone:631-893-3903
Mailing Address - Fax:631-893-3906
Practice Address - Street 1:800 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4919
Practice Address - Country:US
Practice Address - Phone:631-893-3903
Practice Address - Fax:631-893-3906
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219517-1207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH58390Medicare UPIN
NYQ46866Medicare UPIN
NYS55656Medicare UPIN