Provider Demographics
NPI:1992848436
Name:MOJICA, MICHAEL ANTHONY (MICHAEL MOJICA)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:MOJICA
Suffix:
Gender:M
Credentials:MICHAEL MOJICA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 E 36TH ST
Mailing Address - Street 2:APT 10A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3521
Mailing Address - Country:US
Mailing Address - Phone:212-481-0251
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:BELLEVUE HOSPITAL CENTER ROOM 9-WEST-25
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-8147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY181079207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine